Primary Lung Carcinoma with a Component of Large Cell Neuroendocrine Carcinoma (LCNEC)

Abstract

Objective. Large cell neuroendocrine carcinoma (LCNEC) is an uncommon tumor of the lung that is a newly recognized clinicopathologic entity. A small percentage of LCNEC is histologically heterogeneous. The aim of this study is to elucidate the clinicopathologic characteristics of lung carcinoma with a component of LCNEC. Study Design. We retrospectively reviewed 4 cases diagnosed as combined LCNEC or combined small cell carcinoma (SCC) with a component of LCNEC between April 2003 and March 2008. Results. The age of the patients ranged from 65 to 85 years (mean 76.8 years), all were male and had been smokers. In all cases, preoperative positron emission tomography (PET) with ¹⁸F-fluorodeoxyglucose (FDG) revealed high FDG accumulation in the lesions. The surgical modalities were segmentectomy in 1 case, and lobectomy in 3 cases. Two cases were classified as stage I, 1 stage II and 1 stage III. The components with LCNEC were squamous cell carcinoma in 1 case, adenocarcinoma in 1 case and small cell carcinoma in 2 cases. One case had recurrence 10 months after surgery. Conclusion. We could not clarify the prognosis of lung carcinoma with a component of LCNEC in this study. But since preoperative FDG-PET revealed high FDG accumulation at the lesions in all cases, lung carcinoma with a component of LCNEC is considered to be a high-grade malignant tumor of the lung. We need further experience of such cases to elucidate optimal therapy and prognosis of this tumor of the lung.