Pathohistology
MACROSCOPIC DESCRIPTION
1. Specimen container labelled 'left tracheal biopsy'. A tan tissue fragment, 3 mm.
2. Specimen container labelled '(R) main bronchus tumour'. Three tan tissue fragments, admixed with blood clot, ranging in size from 5-10 mm.
MICROSCOPIC DESCRIPTION
1. Sections show a single fragment of bronchial tissue. This comprises respiratory type epithelium with attached fibrous stroma infiltrated by nests of epithelioid cells. These cells have rounded nuclei, finely divided chromatin, and moderately abundant amphophilic cytoplasm. The appearances are in keeping a carcinoid tumour. There is no mitotic
activity or necrosis to suggest that this is an atypical carcinoid, based on a small sample.
2. Sections show fragments of bronchial tissue, widely infiltrated by tumour nests with similar features to those described for specimen 1. The growth pattern is also partly trabecular. No necrosis is seen. Up to two mitoses per 10 high power fields are identified. Definite evidence to
place the tumour in the atypical carcinoid category is not identified based on these small samples.
DIAGNOSIS
1&2 Left tracheal biopsy and right main bronchus tumour biopsy - recurrent carcinoid tumour.