The pitfalls in cytology diagnosis of poorly differentiated neuroendocrine carcinoma of lung and their treatment response

Debarshi Saha, Ankit Kumar, Sourjya Banerjee, M. Nirupama, H. B. Sridevi, Priya Garg, Flora D. Lobo

Research output: Contribution to journalArticle

Abstract

Context: Lung is the most common site of small cell carcinoma (SCLC) - a poorly differentiated neuroendocrine carcinoma (PDNEC). SCLC comprises 15-20% of the invasive cancers of the lung. Aim: This study was conducted to appraise the accuracy and pitfalls of the diagnosis of PDNEC on cytology along with treatment responses if available. Settings and Design: Retrospective study for 2 years yielded 21 cases on cytology. Subjects and Methods: Slides of fine-needle aspiration of lymph nodes, the tumor, bronchial brush, and bronchoalveolar lavage specimens were used. The histological correlation was obtained as were treatment responses. Results: Eighteen SCLCs were confirmed on review. Of these, 13 initial reports were concordant and five, discordant. The rest three cases which initially reported as SCLC were found to be negative (2) and combined SCLC (1). One SCLC with concordant initial and reviewed diagnoses failed to confirm on histopathology. The patients, all heavy smokers, were predominantly males in the seventh to eighth decade age group. The sensitivity and specificity of reviewed diagnoses were better than that of the original. The difference between histopathology and cytology diagnoses (reviewed and original) was statistically insignificant. All patients were categorized as 'extensive stage' by positron emission tomography-computerized tomography, and five were treated with etoposide and cisplatin with/without radiotherapy. Conclusion: Age group (61-70) and gender (males) distribution were statistically significant. Intermediate variants of SCLC may be misdiagnosed as adenocarcinoma. Similarly, combined SCLC may be missed on cytology if the observer does not sustain a high index of suspicion. Unequivocal cytology diagnosis opposed to negative histopathology report demands repeat biopsy.

Original languageEnglish
Pages (from-to)213-217
Number of pages5
JournalJournal of Cancer Research and Therapeutics
Volume13
Issue number2
DOIs
Publication statusPublished - 01-04-2017

Fingerprint

Neuroendocrine Carcinoma
Small Cell Carcinoma
Cell Biology
Lung
Bronchoalveolar Lavage
Therapeutics
Age Groups
Etoposide
Fine Needle Biopsy
Diagnostic Errors
Positron-Emission Tomography
Cisplatin
Lung Neoplasms
Adenocarcinoma
Radiotherapy
Retrospective Studies
Lymph Nodes
Tomography
Biopsy
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{4c92f0c6dbcf493f8e887bf7e8093148,
title = "The pitfalls in cytology diagnosis of poorly differentiated neuroendocrine carcinoma of lung and their treatment response",
abstract = "Context: Lung is the most common site of small cell carcinoma (SCLC) - a poorly differentiated neuroendocrine carcinoma (PDNEC). SCLC comprises 15-20{\%} of the invasive cancers of the lung. Aim: This study was conducted to appraise the accuracy and pitfalls of the diagnosis of PDNEC on cytology along with treatment responses if available. Settings and Design: Retrospective study for 2 years yielded 21 cases on cytology. Subjects and Methods: Slides of fine-needle aspiration of lymph nodes, the tumor, bronchial brush, and bronchoalveolar lavage specimens were used. The histological correlation was obtained as were treatment responses. Results: Eighteen SCLCs were confirmed on review. Of these, 13 initial reports were concordant and five, discordant. The rest three cases which initially reported as SCLC were found to be negative (2) and combined SCLC (1). One SCLC with concordant initial and reviewed diagnoses failed to confirm on histopathology. The patients, all heavy smokers, were predominantly males in the seventh to eighth decade age group. The sensitivity and specificity of reviewed diagnoses were better than that of the original. The difference between histopathology and cytology diagnoses (reviewed and original) was statistically insignificant. All patients were categorized as 'extensive stage' by positron emission tomography-computerized tomography, and five were treated with etoposide and cisplatin with/without radiotherapy. Conclusion: Age group (61-70) and gender (males) distribution were statistically significant. Intermediate variants of SCLC may be misdiagnosed as adenocarcinoma. Similarly, combined SCLC may be missed on cytology if the observer does not sustain a high index of suspicion. Unequivocal cytology diagnosis opposed to negative histopathology report demands repeat biopsy.",
author = "Debarshi Saha and Ankit Kumar and Sourjya Banerjee and M. Nirupama and Sridevi, {H. B.} and Priya Garg and Lobo, {Flora D.}",
year = "2017",
month = "4",
day = "1",
doi = "10.4103/0973-1482.192761",
language = "English",
volume = "13",
pages = "213--217",
journal = "Journal of Cancer Research and Therapeutics",
issn = "0973-1482",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "2",

}

The pitfalls in cytology diagnosis of poorly differentiated neuroendocrine carcinoma of lung and their treatment response. / Saha, Debarshi; Kumar, Ankit; Banerjee, Sourjya; Nirupama, M.; Sridevi, H. B.; Garg, Priya; Lobo, Flora D.

In: Journal of Cancer Research and Therapeutics, Vol. 13, No. 2, 01.04.2017, p. 213-217.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The pitfalls in cytology diagnosis of poorly differentiated neuroendocrine carcinoma of lung and their treatment response

AU - Saha, Debarshi

AU - Kumar, Ankit

AU - Banerjee, Sourjya

AU - Nirupama, M.

AU - Sridevi, H. B.

AU - Garg, Priya

AU - Lobo, Flora D.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Context: Lung is the most common site of small cell carcinoma (SCLC) - a poorly differentiated neuroendocrine carcinoma (PDNEC). SCLC comprises 15-20% of the invasive cancers of the lung. Aim: This study was conducted to appraise the accuracy and pitfalls of the diagnosis of PDNEC on cytology along with treatment responses if available. Settings and Design: Retrospective study for 2 years yielded 21 cases on cytology. Subjects and Methods: Slides of fine-needle aspiration of lymph nodes, the tumor, bronchial brush, and bronchoalveolar lavage specimens were used. The histological correlation was obtained as were treatment responses. Results: Eighteen SCLCs were confirmed on review. Of these, 13 initial reports were concordant and five, discordant. The rest three cases which initially reported as SCLC were found to be negative (2) and combined SCLC (1). One SCLC with concordant initial and reviewed diagnoses failed to confirm on histopathology. The patients, all heavy smokers, were predominantly males in the seventh to eighth decade age group. The sensitivity and specificity of reviewed diagnoses were better than that of the original. The difference between histopathology and cytology diagnoses (reviewed and original) was statistically insignificant. All patients were categorized as 'extensive stage' by positron emission tomography-computerized tomography, and five were treated with etoposide and cisplatin with/without radiotherapy. Conclusion: Age group (61-70) and gender (males) distribution were statistically significant. Intermediate variants of SCLC may be misdiagnosed as adenocarcinoma. Similarly, combined SCLC may be missed on cytology if the observer does not sustain a high index of suspicion. Unequivocal cytology diagnosis opposed to negative histopathology report demands repeat biopsy.

AB - Context: Lung is the most common site of small cell carcinoma (SCLC) - a poorly differentiated neuroendocrine carcinoma (PDNEC). SCLC comprises 15-20% of the invasive cancers of the lung. Aim: This study was conducted to appraise the accuracy and pitfalls of the diagnosis of PDNEC on cytology along with treatment responses if available. Settings and Design: Retrospective study for 2 years yielded 21 cases on cytology. Subjects and Methods: Slides of fine-needle aspiration of lymph nodes, the tumor, bronchial brush, and bronchoalveolar lavage specimens were used. The histological correlation was obtained as were treatment responses. Results: Eighteen SCLCs were confirmed on review. Of these, 13 initial reports were concordant and five, discordant. The rest three cases which initially reported as SCLC were found to be negative (2) and combined SCLC (1). One SCLC with concordant initial and reviewed diagnoses failed to confirm on histopathology. The patients, all heavy smokers, were predominantly males in the seventh to eighth decade age group. The sensitivity and specificity of reviewed diagnoses were better than that of the original. The difference between histopathology and cytology diagnoses (reviewed and original) was statistically insignificant. All patients were categorized as 'extensive stage' by positron emission tomography-computerized tomography, and five were treated with etoposide and cisplatin with/without radiotherapy. Conclusion: Age group (61-70) and gender (males) distribution were statistically significant. Intermediate variants of SCLC may be misdiagnosed as adenocarcinoma. Similarly, combined SCLC may be missed on cytology if the observer does not sustain a high index of suspicion. Unequivocal cytology diagnosis opposed to negative histopathology report demands repeat biopsy.

UR - http://www.scopus.com/inward/record.url?scp=85021826763&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021826763&partnerID=8YFLogxK

U2 - 10.4103/0973-1482.192761

DO - 10.4103/0973-1482.192761

M3 - Article

VL - 13

SP - 213

EP - 217

JO - Journal of Cancer Research and Therapeutics

JF - Journal of Cancer Research and Therapeutics

SN - 0973-1482

IS - 2

ER -