J.Jpn. Surg. Soc.. 122(1): 10-17, 2021

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Feature topic

THE ROLE OF THE CYTOLOGICAL APPROACH TO NEUROENDOCRINE TUMORS:PRETREATMENT DIAGNOSIS

Cytological and histopathological approaches are important for the effective management of patients with lung and mediastinal tumors with significant implications for molecular testing. Lung and mediastinal neuroendocrine tumors are classified into the following categories: typical carcinoid; atypical carcinoid; large-cell neuroendocrine carcinoma; and small-cell lung cancer. Lobectomy with lymph node dissection is the standard surgical procedure for low-grade neuroendocrine tumors (e.g., typical and atypical carcinoids). However, chemotherapy remains the mainstay of treatment for high-grade neuroendocrine tumors (e.g., small-cell lung cancer) because these patients usually present with extensive disease at the time of diagnosis. Therefore, accurate pretreatment diagnosis is important. A cytological approach is useful in patients with lung and mediastinal tumors in whom biopsies are difficult to perform. Although the cytological characteristics of large-cell neuroendocrine carcinoma have recently been established, differentiating these lesions from small-cell lung cancer is challenging. An appropriate cytological approach is clinically beneficial for the management of neuroendocrine tumors.

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