Skip to main content

Advertisement

Log in

Primary Pulmonary Primitive Neuroectodermal Tumor (PNET): A Clinicopathological and Immunohistochemical Study of Six Cases

  • Published:
Lung Aims and scope Submit manuscript

Abstract

Background

The clinicopathological and immunohistochemical features of six primary pulmonary primitive neuroectodermal tumors (PNETs) are reported.

Methods

The patients were four men and two women aged 22–56 years (mean = 32.3 years). The main presenting symptoms included chest pain, shortness of breath, and cough. The tumor size ranged from 4 to 9.6 cm.

Results

Macroscopically, the tumors were circumscribed, yellow-white in color, and of soft and friable consistency. Histologically, the lesions were composed of a monomorphic population of solidly packed round cells with a round-to-ovoid nucleus, fine chromatin, small nucleoli, and scanty pale cytoplasm. Immunohistochemically, the tumor cells were uniformly positive for CD99, neuron-specific enolase, and vimentin, and single cases focally expressed cytokeratin and S100. Fluorescence in situ hybridization analysis performed in two cases showed positive rearrangement for the EWSR1 gene at the 22q12 locus. Follow-up information available for four patients showed that three had died 24–54 months after diagnosis and one patient is alive 11 months after diagnosis. Two patients were lost to follow-up.

Conclusion

Primary PNETs of the lung are rare tumors that need to be added to the differential diagnosis of primary pulmonary neoplasms composed of small cells. Awareness of this entity as a primary pulmonary neoplasm is required in order to avoid misdiagnosis and unsuitable treatment of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Weiss SW, Goldblum JR (2008) Primitive neuroectodermal tumors and related lesions. In: Weiss SW, Goldblum JR (eds) Soft tissue tumors, 5th edn. Mosby Elsevier, Maryland Heights, pp 945–987

  2. Stephenson J, Gow KW, Meehan J, Hawkins DS, Avansino J (2011) Ewing sarcoma/primitive neuroectodermal tumor arising from the adrenal gland in an adolescent. Pediatr Blood Cancer 57:691–692

    Article  PubMed  Google Scholar 

  3. Jimenez RE, Folpe AL, Ro JY, Lapham RL, O’Shea PA, Weiss SW, Amin MB (2002) Primary Ewing’s sarcoma/primitive neuroectodermal tumor of the kidney: a clinicopathologic and immunohistochemical analysis of 11 cases. Am J Surg Pathol 26:320–327

    Article  PubMed  Google Scholar 

  4. Cambruzzi E, Guerra EE, Hilgert HC, Schmitz HJ, Silva VL, Cruz RP, Milani DM, Pruinelli R (2011) Primitive neuroectodermal tumor of the liver: a case report. Case Rep Med 2011:748194

    Google Scholar 

  5. Askin FB, Rosai J, Sibley RK, Dehner LP, McAlister WH (1979) Malignant small cell tumor of the thoracopulmonary region in childhood: a distinctive clinicopathologic entity of uncertain histogenesis. Cancer 43:2438–2451

    Article  PubMed  CAS  Google Scholar 

  6. Tsuji S, Hisaoka M, Morimitsu Y, Hashimoto H, Jimi A, Watanabe J, Eguchi H, Kaneko Y (1998) Peripheral primitive neuroectodermal tumour of the lung: report of two cases. Histopathology 33:369–374

    Article  PubMed  CAS  Google Scholar 

  7. Imamura F, Funakoshi T, Nakamura S, Mano M, Kodama K, Horai T (2000) Primary primitive neuroectodermal tumor of the lung: report of two cases. Lung Cancer 27:55–60

    Article  PubMed  CAS  Google Scholar 

  8. Baumgartner FJ, Omari BO, French SW (2001) Primitive neuroectodermal tumor of the pulmonary hilum in an adult. Ann Thorac Surg 72:285–287

    Article  PubMed  CAS  Google Scholar 

  9. Kahn AG, Avagnina A, Nazar J, Elsner B (2001) Primitive neuroectodermal tumor of the lung. Arch Pathol Lab Med 125:397–399

    PubMed  CAS  Google Scholar 

  10. Mikami Y, Nakajima M, Hashimoto H, Irei I, Matsushima T, Kawabata S, Manabe T (2001) Primary pulmonary primitive neuroectodermal tumor (PNET). A case report. Pathol Res Pract 197:113–119

    PubMed  CAS  Google Scholar 

  11. Takahashi D, Nagayama J, Nagatoshi Y, Inagaki J, Nishiyama K, Yokoyama R, Moriyasu Y, Okada K, Okamura J (2007) Primary Ewing’s sarcoma family tumors of the lung: a case report and review of the literature. Jpn J Clin Oncol l37:874–877

    Article  Google Scholar 

  12. Demir A, Dagoglu N, Gunluoglu MZ, Turna A, Dizdar Y, Kaynak K, Dilege S, Mandel NM, Yilmazbayhan D, Dincer SI, Gurses A (2009) Surgical treatment and prognosis of primitive neuroectodermal tumors of the thorax. J Thorac Oncol l4:185–192

    Article  Google Scholar 

  13. Hancorn K, Sharma A, Shackcloth M (2010) Primary extraskeletal Ewing’s sarcoma of the lung. Interact Cardiovasc Thorac Surg 10:803–804

    Article  PubMed  Google Scholar 

  14. Lawlor ER, Mathers JA, Bainbridge T, Horsman DE, Kawai A, Healey JH, Huvos AG, Bridge JA, Ladanyi M, Sorensen PH (1998) Peripheral primitive neuroectodermal tumors in adults: documentation by molecular analysis. J Clin Oncol l16:1150–1157

    Google Scholar 

  15. Applebaum MA, Worch J, Goldsby R, Matthay KK, Neuhaus J, West DC, Dubois SG (2011) Clinical features and outcomes in patients with extraskeletal Ewing sarcoma. Cancer 117:3027–3032

    Article  PubMed  Google Scholar 

  16. Daya D, Lukka H, Clement PB (1992) Primitive neuroectodermal tumors of the uterus: a report of four cases. Hum Pathol 23:1120–1129

    Article  PubMed  CAS  Google Scholar 

  17. Fukunaga M, Nomura K, Endo Y, Ushigome S, Aizawa S (1996) Carcinosarcoma of the uterus with extensive neuroectodermal differentiation. Histopathology 29:565–570

    Article  PubMed  CAS  Google Scholar 

  18. Dehner LP (1993) Primitive neuroectodermal tumor and Ewing’s sarcoma. Am J Surg Pathol 17:1–13

    Article  PubMed  CAS  Google Scholar 

  19. Thornton JL, Conquest HF, Massie JR, Coxe JW 3rd (1965) Primary pulmonary rhabdomyosarcoma: report of three cases and literature review. Ann Surg 161:688–692

    Article  PubMed  Google Scholar 

  20. McDonald S Jr, Heather JC (1939) Neoplastic invasion of the pulmonary veins and left auricle. J Pathol Bacteriol 48:533–543

    Article  Google Scholar 

  21. McCormack RJ, Drennan JM (1960) Primary rhabdomyosarcoma of the lung. J Pathol Bacteriol l79:147–149

    Google Scholar 

  22. Aterman K, Patel S (1970) Striated muscle in the lung. Am J Anat 128:341–358

    Article  PubMed  CAS  Google Scholar 

  23. Gu M, Antonescu CR, Guiter G, Huvos AG, Ladanyi M, Zakowski MF (2000) Cytokeratin immunoreactivity in Ewing’s sarcoma: prevalence in 50 cases confirmed by molecular diagnostic studies. Am J Surg Pathol 24:410–416

    Article  PubMed  CAS  Google Scholar 

  24. Ladanyl M, Heinemann FS, Huvos AG, Rao PH, Chen QG, Jhanwar SC (1990) Neural differentiation in small round cell tumors of bone and soft tissue with the translocation t(11;22) (q24;q12): an immunohistochemical study of 11 cases. Hum Pathol 21:1245–1251

    Article  PubMed  CAS  Google Scholar 

  25. Tongaonkar HB, Thyavihally YB, Gupta S, Kurkure PA, Amare P, Muckaden MA, Desai SB (2008) Primitive neuroectodermal tumor of the kidney: a single institute series of 16 patients. Urology 71:292–296

    Article  PubMed  Google Scholar 

  26. Charney DA, Ghali VS, Charney JM, Teplitz C (1996) Primitive neuroectodermal tumor of the myocardium: a case report, review of the literature, immunohistochemical, and ultrastructural study. Hum Pathol 27:1365–1369

    Article  PubMed  CAS  Google Scholar 

  27. Chang HL, Rosenberg AE, Friedmann AM, Ryan DP, Masiakos PT (2008) Primary pulmonary rhabdomyosarcoma in a 5-month-old boy: a case report. J Pediatr Hematol Oncol 30:461–463

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Annikka Weissferdt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Weissferdt, A., Moran, C.A. Primary Pulmonary Primitive Neuroectodermal Tumor (PNET): A Clinicopathological and Immunohistochemical Study of Six Cases. Lung 190, 677–683 (2012). https://doi.org/10.1007/s00408-012-9405-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-012-9405-9

Keywords

Navigation