1. Carcinoid

2. Classification of Bronchial NET
Histological type 
Necrosis 
Mitotic count 
TC 
absent 
<2/10 HPF 
AC 
present focal 
2–9/10 HPF 
LCNEC 
present (extensive) 
>9/10 HPF 
SCLC 
>50/10 HPF 
TC: typical carcinoid LCNEC: large-cell neuroendocrine carcioma
AC: atypical carcinoid SCLC: small-cell carcinoma.

4. Diagnosis NSE neuron-specific enolase 5HIAA
Clinical symptoms bronchial NET 
 Hemoptysis, cough, recurrent pulmonary infections, wheezing 
 Carcinoid syndrome 
Rare 
 Cushing's syndrome 
Clinical symptoms thymic NET 
 Chest discomfort, superior vena cava syndrome, stridor, Cushing's syndrome, acromegaly 
Pathology 
 Histopathology 
 Immunohistochemistry (chromogranin A, synaptophysin, CD56, Ki-67) 
Biochemistry (specific) 
 p-Chromogranin A, p-NSE, u-5HIAA, [au-cortisol, p-ACTH, p-GHRH, IGF-1] 
Imaging 
 Multislice CT scan 
 111In-DTPA-scintigraphy: (Octreoscan®) 
PET: 68Ga-DOTATATE, FDG 
Bronchoscopy 
Genetic screening 
 MEN-1 genetic screening when suspected 
Diagnosis
NSE
neuron-specific enolase
5HIAA
5-hydroxy indol acetic acid

7. Neuroendocrine Tumours (NET) Follow-up
After primary surgery: patients with TC and AC at least yearly up to 15 years
Biochemical markers e.g. chromogranin A & NSE, should be determined every 3–6 months (in cases with elevated values at baseline)
CT should be performed:
once a year in atypical carcinoid &
every 2 or 3 years in typical carcinoid
Patients with metastatic or recurrent disease should be followed during treatment with cytotoxic or biological agents more often, at 3–6-month intervals with imaging, preferably by CT and biological markers to assess possible benefits of the treatment administered