Difference between revisions of "Small cell carcinoma of the lung"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      =  
| Image      = Lung_small_cell_carcinoma_%281%29_by_core_needle_biopsy.jpg
| Width      =
| Width      =
| Caption    =  
| Caption    = Lung small cell carcinoma. [[H&E stain]].
| Synonyms  =
| Synonyms  =
| Micro      = stippled chromatin, high [[NC ratio]] with scant basophilic cytoplasm, typically small cells (~2x [[RBC]] diameter), +/-nuclear moulding, smudgy appearance [[Azzopardi phenonmenon]], necrosis, [[mitoses]]
| Micro      = stippled chromatin, high [[NC ratio]] with scant basophilic cytoplasm, typically small cells (~2x [[RBC]] diameter), +/-nuclear moulding, nuclei with smudgy appearance ([[Azzopardi phenomenon]]), necrosis, [[mitoses]]
| Subtypes  =
| Subtypes  = large cell neuroendocrine carcinoma (LCNEC)
| LMDDx      =
| LMDDx      = poorly differentiated [[adenocarcinoma of the lung]], [[atypical carcinoid]], [[lung carcinoid]], metastatic [[small cell carcinoma]], [[lymphoma]], other [[small round blue cell tumours]]
| Stains    = chromogranin +ve, synaptophysin +ve, CD56 +ve, NSE +ve, TTF-1 +ve
| Stains    = chromogranin +ve, synaptophysin +ve, CD56 +ve, NSE +ve, TTF-1 +ve
| IHC        =
| IHC        =
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| ClinDDx    = other lung tumours ([[squamous cell carcinoma of the lung]]), metastatic tumours
| ClinDDx    = other lung tumours ([[squamous cell carcinoma of the lung]]), metastatic tumours
| Tx        = medical (chemotherapy)
| Tx        = medical (chemotherapy)
}
}}
'''Small cell carcinoma of the lung''', also '''small cell lung carcinoma''' (abbreviated '''SCLC''')<ref name=pmid20943645/> is an aggressive [[malignant]] [[Lung tumours|tumour of the lung]]. It is strongly associated with [[smoking]].
'''Small cell carcinoma of the lung''', also '''small cell lung carcinoma''' (abbreviated '''SCLC''')<ref name=pmid20943645/> is an aggressive [[malignant]] [[Lung tumours|tumour of the lung]]. It is strongly associated with [[smoking]].


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*Typically small cells ~2x RBC diameter.
*Typically small cells ~2x RBC diameter.
*+/-Nuclear moulding.
*+/-Nuclear moulding.
*Necrosis.
*Nuclei with a smudgy appearance ([[Azzopardi phenomenon]]).
*[[Necrosis]].
*Mitoses.
*Mitoses.


Notes:
Notes:
*There should be no nucleolus.
*There should be no [[nucleolus]].


DDx:
DDx:
*Poorly differentiated [[adenocarcinoma of the lung]].
*Metastatic [[small cell carcinoma]].
*Metastatic [[small cell carcinoma]].
*[[Lymphoma]].
*[[Lymphoma]].
*[[Atypical carcinoid]].
*[[Atypical carcinoid]].
*Other [[small round blue cell tumours]].
*Other [[small round blue cell tumours]].
===Subtypes===
*Large cell neuroendocrine carcinoma (LCNEC).
*Large cell neuroendocrine carcinoma (LCNEC).


Revision as of 14:14, 5 January 2014

Small cell carcinoma of the lung
Diagnosis in short

Lung small cell carcinoma. H&E stain.
LM stippled chromatin, high NC ratio with scant basophilic cytoplasm, typically small cells (~2x RBC diameter), +/-nuclear moulding, nuclei with smudgy appearance (Azzopardi phenomenon), necrosis, mitoses
Subtypes large cell neuroendocrine carcinoma (LCNEC)
LM DDx poorly differentiated adenocarcinoma of the lung, atypical carcinoid, lung carcinoid, metastatic small cell carcinoma, lymphoma, other small round blue cell tumours
Stains chromogranin +ve, synaptophysin +ve, CD56 +ve, NSE +ve, TTF-1 +ve
Clinical history smoking - usually a long history, heavy
Prevalence not common
Prognosis poor
Clin. DDx other lung tumours (squamous cell carcinoma of the lung), metastatic tumours
Treatment medical (chemotherapy)

Small cell carcinoma of the lung, also small cell lung carcinoma (abbreviated SCLC)[1] is an aggressive malignant tumour of the lung. It is strongly associated with smoking.

General

  • Strong association with smoking.
  • Typically treated with chemotherapy.
  • Poor prognosis.

On a spectrum of lesions (benign to malignant):[1]

Precursor lesion - uncommonly seen:

  • Pulmonary neuroendocrine cell hyperplasia.[1]

Gross

  • Central location (close to large airways) - typical.
  • Necrosis.

Microscopic

Features:

  • Stippled chromatin.
  • High NC ratio, scant basophilic cytoplasm.
  • Typically small cells ~2x RBC diameter.
  • +/-Nuclear moulding.
  • Nuclei with a smudgy appearance (Azzopardi phenomenon).
  • Necrosis.
  • Mitoses.

Notes:

DDx:

Subtypes

  • Large cell neuroendocrine carcinoma (LCNEC).

Images

  • SCLC - low mag. (WC)

  • SCLC - high mag. (WC)

IHC

  • Synaptophysin +ve.
    • May be very weak.
  • TTF-1 +ve (15 of 16 cases).[2]

Sign out

LOWER LOBE OF LUNG, LEFT, CORE BIOPSY:
- SMALL CELL CARCINOMA.

See also

References

  1. ↑ 1.0 1.1 1.2 Travis, WD. (Oct 2010). "Advances in neuroendocrine lung tumors.". Ann Oncol 21 Suppl 7: vii65-71. doi:10.1093/annonc/mdq380. PMID 20943645.
  2. ↑ Wu, M.; Szporn, AH.; Zhang, D.; Wasserman, P.; Gan, L.; Miller, L.; Burstein, DE. (Oct 2005). "Cytology applications of p63 and TTF-1 immunostaining in differential diagnosis of lung cancers.". Diagn Cytopathol 33 (4): 223-7. doi:10.1002/dc.20337. PMID 16138374.
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