Image Based Question – 74452

A patient presented with a 4 months’ history of cough with diarrheal episodes. Bronchoscopy revealed an intrabronchial polyp. Biopsy from the polyp showed atypical cells with microscopic necrosis and 5 mitotic figures per 10 high-power fields as shown below. Chromogranin staining was positive. What is the diagnosis and grade of the lesion?

A. Atypical carcinoid grade 2

B. Carcinoid grade 1

C. Small cell carcinoma grade IV

D. Large cell ncuroendocrine carcinoma Grade IV

Correct Answer » A Explanation

Ans: A. Atypical carcinoid grade 2

(Ref: Robbins 9/e p719-720).

• History of diarrhea with cough and associated findings are suggestive of carcinoid syndrome.
• Positivity for chrontogranin confirms the neuroendocrine origin of the tumor.
• Typical carcinoids have
• These are traditionally classified
• as grade 2 carcinoids.
• Hence the patient is having a grade 2 atypical carcinoid.