Journal of Nippon Medical School: Vol.68 No.4 page.335

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ArticleTitle High Survival Rate of 6 Cases of Pulmonary Large Cell Neuroendocrine Carcinoma Formerly Classified as Small Cell Carcinoma

AuthorList Miho Yamanishi¹, Susumu Takeuchi¹, Ryuhei Kurashina¹, Masashi Kawamoto², Kiyoshi Koizumi³, Masahiko Shibuya⁴, Daisuke Okada^{2, 3}, Shuji Haraguchi³, Akinobu Yoshimura⁴, Akihiko Gemma⁴, Shoji Kudoh⁴, Shigeo Tanaka³ and Nobuaki Yamanaka²

Affiliation Medical student¹, Departments of Pathology², Surgery (II) ³, and Internal Medicine (IV) ⁴, Nippon Medical School

Language EN

Volume 68

Issue 4

Year 2001

Page 335-339

Received December. 25, 2000

Accepted January 19, 2001

Keywords large cell neuroendocrine carcinoma, lung, multimodality therapy, small cell carcinoma

Abstract In the revised WHO classification of lung cancer, published in 1999, large cell neuroendocrine carcinoma (LCNEC) was employed as a new histological entity. LCNEC is generally considered a high-grade malignant lung cancer, and appropriate treatment remains to be determined. Before its new classification, LCNEC had long been classified into several entities. Advancing the review of previous cases in Nippon Medical School Hospital, we noticed that some LCNEC patients were formally diagnosed as having small cell lung cancer (SCLC), and they showed long-term survival. Material and Methods: All histological specimens of surgically resected SCLC in Nippon Medical School Hospital were reclassified according to the 1999 WHO classification manual. Their neuroendocrine differentiations were confirmed by the use of immunostainings with chromogranin A and synaptophysin. Results: Fourteen cases satisfied the qualifications for both histological and clinical reevaluation. Among them, 6 patients were reclassified as LCNEC, and their stage distribution was as follow: IA; 1, IB; 2, IIIA; 2, and IIIB; 1. Their survival term ranged from 33.8 to 78.0 months; 5 were still alive, and 1 (IIIB) died 57.6 months after surgery. Discussion: According to this study, all the LCNEC patients who were treated as SCLC patients showed more favorable prognoses than patients described in published studies, even overall lung cancer. Therefore, it is suggested that multimodality therapy for SCLC may improve the prognoses of patients with LCNEC.

Correspondence to Masashi Kawamoto, MD, Department of Pathology (I), Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
kawamoto@nms.ac.jp

ArticleTitle	High Survival Rate of 6 Cases of Pulmonary Large Cell Neuroendocrine Carcinoma Formerly Classified as Small Cell Carcinoma
AuthorList	Miho Yamanishi¹, Susumu Takeuchi¹, Ryuhei Kurashina¹, Masashi Kawamoto², Kiyoshi Koizumi³, Masahiko Shibuya⁴, Daisuke Okada^{2, 3}, Shuji Haraguchi³, Akinobu Yoshimura⁴, Akihiko Gemma⁴, Shoji Kudoh⁴, Shigeo Tanaka³ and Nobuaki Yamanaka²
Affiliation	Medical student¹, Departments of Pathology², Surgery (II) ³, and Internal Medicine (IV) ⁴, Nippon Medical School
Language	EN
Volume	68
Issue	4
Year	2001
Page	335-339
Received	December. 25, 2000
Accepted	January 19, 2001
Keywords	large cell neuroendocrine carcinoma, lung, multimodality therapy, small cell carcinoma
Abstract	In the revised WHO classification of lung cancer, published in 1999, large cell neuroendocrine carcinoma (LCNEC) was employed as a new histological entity. LCNEC is generally considered a high-grade malignant lung cancer, and appropriate treatment remains to be determined. Before its new classification, LCNEC had long been classified into several entities. Advancing the review of previous cases in Nippon Medical School Hospital, we noticed that some LCNEC patients were formally diagnosed as having small cell lung cancer (SCLC), and they showed long-term survival. Material and Methods: All histological specimens of surgically resected SCLC in Nippon Medical School Hospital were reclassified according to the 1999 WHO classification manual. Their neuroendocrine differentiations were confirmed by the use of immunostainings with chromogranin A and synaptophysin. Results: Fourteen cases satisfied the qualifications for both histological and clinical reevaluation. Among them, 6 patients were reclassified as LCNEC, and their stage distribution was as follow: IA; 1, IB; 2, IIIA; 2, and IIIB; 1. Their survival term ranged from 33.8 to 78.0 months; 5 were still alive, and 1 (IIIB) died 57.6 months after surgery. Discussion: According to this study, all the LCNEC patients who were treated as SCLC patients showed more favorable prognoses than patients described in published studies, even overall lung cancer. Therefore, it is suggested that multimodality therapy for SCLC may improve the prognoses of patients with LCNEC.
Correspondence to	Masashi Kawamoto, MD, Department of Pathology (I), Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan kawamoto@nms.ac.jp