Güncel Patoloji Dergisi 2018, Cilt 2, Özel Sayı
Pulmoner Patoloji
Cemile Özdemir 1, Halide Nur Ürer 2, Nural Ören 2
1 Health Sciences University Haseki Training Hospital
2 Health Sciences University Yedikule Chest Diseases Training Hospital
  INTRODUCTION: Small cell carcinoma has a percentage of %13 in all primary lung cancer cases. It’s one of a high degree neuroendocrine tumors in lungs. It takes place generally in central sites and is observed as layers, folds or separated individually at bronchial submucosal sites. Nevertheless intraepitelial spread is rare. We wanted to present small cell carcinoma case as it interestingly spreads in mucosal intraepitelial sites. .

CASE: Male, 36 years old. Bronchoscopy and endobroncial ultrasonography (EBUS) was applied to the patient who suffered from chest pain. Positron emission tomography (PET) showed multiple mediastinal lymphanedopaties and one lesion, measuring 3 cm, in right upper lobe apical segment. White coloured submucosal infiltrations were observed by bonchoscopy and were sampled. Transbronchial needle aspiration (TBNA) was applied in lymph node that is placed in the right lower paratracheal site by using convex EBUS method. Submucosal infiltrative spread of tumor groups were observed in bronch biopsy. The groups were consisted of small or middle sized tumor cells with narrow cytoplasm, and large nucleus with dark chromatins. Thus at the same time intraepitelial tumor cell spread was identified. Necrosis and smash artefact were also seen within the tumor. The same existed in cytomorphologic TBNA samples. The data was suitable with the small cell carcinoma case results when the biopsy and cytological samples were evaluated together. Interestingly tumor cell spread in intact bronchial mucosa took attention in bronch biopsy samples. Immunohistochemical study supported the diagnosis.

DISCUSSION: Neuroendocrinal tumors in lungs are rarely seen making intraepitelial spread. It’s reported that large cell neuroendocrine carcinoma shows spread in bronch epitelium at the level of %19. We would like to share our interesting results that show us intraepitelial tumor spread can be identified in limited high grade neuroendocrine lung carcinoma tissue samples.
Anahtar Kelimeler : Keywords: Intraepithelial spread, small cell carcinoma.