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Difference between revisions of "Non-small cell lung carcinoma"
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Non-small cell lung carcinoma (view source)
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'''Non-small cell [[lung]] carcinoma''', abbreviated '''NSCLC''', is a malignant epithelial neoplasm of the lung that is ''not'' [[small cell carcinoma of the lung]]. | |||
It can be understood as a synonym for '''large cell carcinoma'''. It is umbrella term that includes [[squamous cell carcinoma of lung]], [[adenocarcinoma of the lung]] and [[adenosquamous carcinoma of the lung]].<ref>{{Cite journal | last1 = Song | first1 = Z. | last2 = Lin | first2 = B. | last3 = Shao | first3 = L. | last4 = Zhang | first4 = Y. | title = Therapeutic efficacy of gefitinib and erlotinib in patients with advanced lung adenosquamous carcinoma. | journal = J Chin Med Assoc | volume = 76 | issue = 9 | pages = 481-5 | month = Sep | year = 2013 | doi = 10.1016/j.jcma.2013.05.007 | PMID = 23769878 }}</ref> | |||
In the clinical context, it is usually referred to as '''non-small cell lung cancer'''; this ignores the fact that not all non-small cell lung cancer fits into the carcinoma category. | |||
==General== | |||
*''Non-small cell lung carcinoma'' can be considered a [[waffle diagnosis]] and as such its use should be limited. | |||
**It is preferable to be more specific if this is possible, i.e. call ''adenocarcinoma'' or ''squamous cell carcinoma''. | |||
*Historically, it was sufficient to differentiate between [[small cell carcinoma of the lung|small cell]] and non-small cell carcinomas, as the treatment for all non-small cell lung carcinomas was the same. | |||
==Microscopic== | |||
Features: | |||
*Large cells with abundant cytoplasm. | |||
*+/-[[Nucleoli]]. | |||
*No stippled chromatin. | |||
**This suggests the ''large cell variant of small cell carcinoma''. | |||
DDx: | |||
*[[Squamous cell carcinoma of the lung]]. | |||
*[[Adenocarcinoma of the lung]]. | |||
*[[Small cell carcinoma of the lung]]. | |||
*Large cell variant of [[small cell carcinoma of the lung]]. | |||
==IHC== | |||
Sloan-Kettering algorithm - Rekhtman ''et al.'':<ref name=pmid21623384>{{Cite journal | last1 = Rekhtman | first1 = N. | last2 = Ang | first2 = DC. | last3 = Sima | first3 = CS. | last4 = Travis | first4 = WD. | last5 = Moreira | first5 = AL. | title = Immunohistochemical algorithm for differentiation of lung adenocarcinoma and squamous cell carcinoma based on large series of whole-tissue sections with validation in small specimens. | journal = Mod Pathol | volume = 24 | issue = 10 | pages = 1348-59 | month = Oct | year = 2011 | doi = 10.1038/modpathol.2011.92 | PMID = 21623384 }}</ref> | |||
{| class="wikitable sortable" | |||
! TTF-1\p63 | |||
! p63 -ve (0% of cells) | |||
! p63 +ve <50% of cells | |||
! p63 +ve >=50% of cells | |||
|- | |||
| TTF-1 +ve >=50% of cells | |||
| [[adenocarcinoma of the lung|Adenocarcinoma]] | |||
| Adenocarcinoma | |||
| Adenocarcinoma | |||
|- | |||
| TTF-1 +ve <50% of cells | |||
| Adenocarcinoma | |||
| Adenocarcinoma | |||
| [[Lung SCC|Squamous carcinoma]] | |||
|- | |||
| TTF-1 -ve (0% of cells) | |||
| Adenocarcinoma | |||
| CK5/6 to determine | |||
| Squamous carcinoma | |||
|} | |||
==See also== | |||
*[[Lung tumours]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Pulmonary pathology]] | |||