A80-4-03 Spindle Cell Carcinoid Tumor of the Lung: A Rare Case Report

Abstract Introduction Lung carcinoids are slowly growing neuroendocrine neoplasms with malignant potential. They are classified as typical and atypical carcinoids depending on histological pattern and are mostly found incidentally on routine chest imaging. It is an uncommon subcategory of lung carcinoid tumors. These tumors exhibit distinctive histopathological and molecular characteristics with important clinical impacts. We present a rare case of spindle cell carcinoid tumor of the lung. Case Description 86-year-old male with a past medical history of high-grade urothelial carcinoma who previously completed chemotherapy. He was evaluated for a progressive right lower lobe lung mass. A positron emission tomography (PET) scan was done, which continued to show low-level uptake; however, it was enlarged from prior scans. He was evaluated by radiation oncology and thoracic surgery and decided to pursue navigational bronchoscopy for tissue diagnosis before further interventions. Robotic navigational bronchoscopy with transbronchial biopsy and a needle with a radial probe endobronchial ultrasound (EBUS) was performed. The right lower lobe mass of the EBUS fine needle aspiration (FNA) was consistent with spindle cell carcinoid. The cell block shows clumps of hypochromatic spindled nuclei with relatively little cytoplasm but without mitosis or necrosis. There is also a “Zellballen” quality to the cell clusters and fibrovascular stroma that surrounds tumor cell nests in keeping with carcinoid. He received radiation therapy to the right lower lobe, as he was not a surgical candidate, and was followed with surveillance CT scans of the chest. Discussion Pulmonary carcinoid tumors approximately constitute 10% of all carcinoid tumors. Carcinoid tumors contribute to between 1% and 6% of all lung tumors. Dyspnea, dry cough, and recurrent infections are common manifestations. Spindle cell carcinoid tumor of the lung is an uncommon variant of the carcinoid tumors, and it is essential to differentiate spindle cell carcinoids from other spindle cell neoplasms such as sarcomatoidcarcinomas and small cell carcinomas, as it has a better prognosis. This abstract is funded by: None