Neuroendocrine Tumors of the Lung: Current Challenges and Advances in the Diagnosis and Management of Well-Differentiated Disease Andrew E. Hendifar,

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Presentation transcript:

Neuroendocrine Tumors of the Lung: Current Challenges and Advances in the Diagnosis and Management of Well-Differentiated Disease Andrew E. Hendifar, MD, MPH, Alberto M. Marchevsky, MD, Richard Tuli, MD, PhD Journal of Thoracic Oncology Volume 12, Issue 3, Pages 425-436 (March 2017) DOI: 10.1016/j.jtho.2016.11.2222 Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Figure 1 Morphologic criteria for distinguishing lung NETs. Tumors with neuroendocrine morphology are divided into the four subtypes primarily according to the number of mitoses and presence or absence of necrosis. NET, neuroendocrine tumor; NE, neuroendocrine. Adapted from Travis8 with permission. Journal of Thoracic Oncology 2017 12, 425-436DOI: (10.1016/j.jtho.2016.11.2222) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Figure 2 Ki-67 labeling index distribution in the four subtypes of lung neuroendocrine tumors: typical carcinoid (A), atypical carcinoid (B), large cell neuroendocrine carcinoma (C), and SCLC (D). Reprinted from Pelosi et al.30 with permission. Journal of Thoracic Oncology 2017 12, 425-436DOI: (10.1016/j.jtho.2016.11.2222) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Figure 3 Diagnostic evaluation/work-up recommendations according to the European Neuroendocrine Tumor Society guidelines for typical carcinoids (TCs) and atypical carcinoids (ACs). aAccurate echocardiographic evaluation should always be carried out before surgical procedures and at both diagnosis and follow-up to evaluate the presence and evolution of carcinoid heart disease. NET, neuroendocrine tumor; MEN-1, multiple endocrine neoplasia type 1; PTH, parathyroid hormone; CT, computed tomography; 5-HIAA, 5-hydroxyindoleacetic acid; ACTH, adrenocorticotropic hormone; GHRH, growth hormone–releasing hormone; IGF-1, insulin growth factor 1; MRI, magnetic resonance imaging; EBUS, endobronchial ultrasonography; PET, positron emission tomography; FDG-PET, fludeoxyglucose F 18 positron emission tomography. Reprinted from Caplin et al.15 with permission. Journal of Thoracic Oncology 2017 12, 425-436DOI: (10.1016/j.jtho.2016.11.2222) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions