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Tumors of the diffuse endocrine system, histochemical and electron-optic aids, and pitfalls in diagnosis.

Tumors of the Diffuse Endocrine System are a heterogeneous group of malignant neoplasms which have rather characteristic light microscopic and cytologic features. These are, however, not diagnostic and their identification with separation from non-neuroendocrine carcinomas require important adjunctive evaluations including histochemical analysis, immunocytochemical characterization and electron-optic identification of endocrine secretory products and paracrine effects in the cytoplasm of the neoplastic cells. The importance of proper classification cannot be over-emphasized because of the often considerable biologic and prognostic differences between neuroendocrine carcinomas and other types of carcinoma, notably metastatic carcinomas from the breast and the prostate. Furthermore, the separation of these lesions into two groups; a small cell type and those with large cells (carcinoid type) appears to have clinical significance in both diagnosis and response to therapy.