Impact of Neuroendocrine Differentiation in Non-small Cell Lung Cancer R. Ilona Linnoila, MD, Steven Piantadosi, MD, PhD, John C. Ruckdeschel, MD, FCCP  CHEST  Volume 106, Issue 6, Pages 367S-371S (December 1994) DOI: 10.1378/chest.106.6_Supplement.367S Copyright © 1994 The American College of Chest Physicians Terms and Conditions

FIGURE 1 Photomicrographs of neuroendocrine markers in lung carcinogenesis. Immunoreactivity of the three general neuroendocrine (NE) markers chromogranin A (ChrA; on the left, panels a, d, g, j), Leu-7 (in the middle, panels b, e, h, k), and neuron-specific enolase (NSK; on the right, panels c, f, i, l) are illustrated in nonneoplastic pulmonary NE cells that serve as positive controls (on the top, panels a through c), and various lung cancer types (panels d through l). a, Two NE cells in bronchiolar epithelium positive for ChrA (Nomarski optics, ×640). b, Leu-7 reactivity in a fetal pulmonary epithelium reveals a bottle-shaped NE cell (×1,150). c, NSE immunoreactivity in an organoid cluster of cells called neuroepithelial body (×580). In 90 to 100% of carcinoid tumors, the immunoreactivity is intense in most cells. d, ChrA (×640); e, Leu-7(×290). Note sharp demarcation between positive tumor (T) and negative stroma (S). f, NSE (×720). In 60% of SCLCs, a more focal immunoreactivity for ChrA. g, (×400) and Leu-7 h, (×460) with clearly negative stromas i, NSE is diffusely positive in 100% of SCLC; note negative stroma (S; ×290). In non-SCLCs with NE features (NSCLC-NE), the degree of immunoreactivity is intermediate. j, a large cell carcinoma with clusters of ChrA positive cells (×460). k, a glandular adenocarcinoma positive for Leu-7 (×290). l. a papillary adenocarcinoma with strong NSE immunoreactivity in tumor, while stroma (S) remains negative (×290). CHEST 1994 106, 367S-371SDOI: (10.1378/chest.106.6_Supplement.367S) Copyright © 1994 The American College of Chest Physicians Terms and Conditions