Difference between revisions of "Small cell carcinoma"
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[[Image:Small cell carcinoma in lymph node -- very high mag.jpg |thumb|300px|[[Micrograph]] showing a small cell carcinoma.]] | |||
'''Small cell carcinoma''' is a type of carcinoma. It is mostly commonly from the [[lung tumours|lung]]; 95% of cases are from the lung.<ref name=pmid21618245/> | '''Small cell carcinoma''' is a type of carcinoma. It is mostly commonly from the [[lung tumours|lung]]; 95% of cases are from the lung.<ref name=pmid21618245/> | ||
It may be abbreviated '''[[SCC]]''', leading to confusion with [[squamous cell carcinoma]]. | It may be abbreviated '''[[SCC]]''', leading to confusion with [[squamous cell carcinoma]]. | ||
=Overview= | ==Overview== | ||
===Grouping=== | ===Grouping=== | ||
May be grouped as:<ref name=pmid21618245>{{Cite journal | last1 = Grossman | first1 = RA. | last2 = Pedroso | first2 = FE. | last3 = Byrne | first3 = MM. | last4 = Koniaris | first4 = LG. | last5 = Misra | first5 = S. | title = Does surgery or radiation therapy impact survival for patients with extrapulmonary small cell cancers? | journal = J Surg Oncol | volume = | issue = | pages = | month = May | year = 2011 | doi = 10.1002/jso.21976 | PMID = 21618245 }}</ref> | May be grouped as:<ref name=pmid21618245>{{Cite journal | last1 = Grossman | first1 = RA. | last2 = Pedroso | first2 = FE. | last3 = Byrne | first3 = MM. | last4 = Koniaris | first4 = LG. | last5 = Misra | first5 = S. | title = Does surgery or radiation therapy impact survival for patients with extrapulmonary small cell cancers? | journal = J Surg Oncol | volume = | issue = | pages = | month = May | year = 2011 | doi = 10.1002/jso.21976 | PMID = 21618245 }}</ref> | ||
| Line 20: | Line 21: | ||
*Breast.<ref name=pmid21657157>{{Cite journal | last1 = Cesaretti | first1 = M. | last2 = Guarnieri | first2 = A. | last3 = Gaggelli | first3 = I. | last4 = Tirone | first4 = A. | last5 = Francioli | first5 = N. | last6 = Carli | first6 = AF. | title = Small cell carcinoma of the breast. Report of a case. | journal = Ann Ital Chir | volume = 82 | issue = 1 | pages = 61-4 | month = | year = | doi = | PMID = 21657157 }}</ref> | *Breast.<ref name=pmid21657157>{{Cite journal | last1 = Cesaretti | first1 = M. | last2 = Guarnieri | first2 = A. | last3 = Gaggelli | first3 = I. | last4 = Tirone | first4 = A. | last5 = Francioli | first5 = N. | last6 = Carli | first6 = AF. | title = Small cell carcinoma of the breast. Report of a case. | journal = Ann Ital Chir | volume = 82 | issue = 1 | pages = 61-4 | month = | year = | doi = | PMID = 21657157 }}</ref> | ||
*Thyroid gland.<ref name=pmid21644012>{{Cite journal | last1 = Beach | first1 = DF. | last2 = Klump | first2 = WJ. | last3 = Haddad | first3 = G. | last4 = Reid | first4 = LM. | last5 = Schwarting | first5 = R. | last6 = Hageboutros | first6 = A. | title = Extrapulmonary small cell: a novel case of small cell carcinoma of the thyroid gland. | journal = Med Oncol | volume = | issue = | pages = | month = Jun | year = 2011 | doi = 10.1007/s12032-011-9996-7 | PMID = 21644012 }}</ref> | *Thyroid gland.<ref name=pmid21644012>{{Cite journal | last1 = Beach | first1 = DF. | last2 = Klump | first2 = WJ. | last3 = Haddad | first3 = G. | last4 = Reid | first4 = LM. | last5 = Schwarting | first5 = R. | last6 = Hageboutros | first6 = A. | title = Extrapulmonary small cell: a novel case of small cell carcinoma of the thyroid gland. | journal = Med Oncol | volume = | issue = | pages = | month = Jun | year = 2011 | doi = 10.1007/s12032-011-9996-7 | PMID = 21644012 }}</ref> | ||
*Liver.<ref name=pmid19669327>{{Cite journal | last1 = Morikawa | first1 = H. | last2 = Nakayama | first2 = Y. | last3 = Maeda | first3 = T. | last4 = Nadatani | first4 = Y. | last5 = Kobayashi | first5 = S. | last6 = Iwai | first6 = S. | last7 = Enomoto | first7 = M. | last8 = Tamori | first8 = A. | last9 = Sakaguchi | first9 = H. | title = A case of primary small cell carcinoma of the liver that was treated with chemotherapy. | journal = Hepatol Int | volume = 2 | issue = 4 | pages = 500-4 | month = Dec | year = 2008 | doi = 10.1007/s12072-008-9090-1 | PMID = 19669327 }}</ref><ref name=pmid18159605>{{Cite journal | last1 = Choi | first1 = SJ. | last2 = Kim | first2 = JM. | last3 = Han | first3 = JY. | last4 = Ahn | first4 = SI. | last5 = Kim | first5 = JS. | last6 = Kim | first6 = L. | last7 = Park | first7 = IS. | last8 = Chu | first8 = YC. | title = Extrapulmonary small cell carcinoma of the liver: clinicopathological and immunohistochemical findings. | journal = Yonsei Med J | volume = 48 | issue = 6 | pages = 1066-71 | month = Dec | year = 2007 | doi = 10.3349/ymj.2007.48.6.1066 | PMID = 18159605 }}</ref> | |||
=General= | ==General== | ||
Classic tumour with paraneoplastic syndromes - may be associated with:<ref name=pmid18316005>{{Cite journal | last1 = Sher | first1 = T. | last2 = Dy | first2 = GK. | last3 = Adjei | first3 = AA. | title = Small cell lung cancer. | journal = Mayo Clin Proc | volume = 83 | issue = 3 | pages = 355-67 | month = Mar | year = 2008 | doi = | PMID = 18316005 }}</ref> | Classic tumour with paraneoplastic syndromes - may be associated with:<ref name=pmid18316005>{{Cite journal | last1 = Sher | first1 = T. | last2 = Dy | first2 = GK. | last3 = Adjei | first3 = AA. | title = Small cell lung cancer. | journal = Mayo Clin Proc | volume = 83 | issue = 3 | pages = 355-67 | month = Mar | year = 2008 | doi = | PMID = 18316005 }}</ref> | ||
*Syndrome of inappropriate antidiuretic hormone secretion (SIADH). | *Syndrome of inappropriate antidiuretic hormone secretion (SIADH). | ||
| Line 28: | Line 30: | ||
*Lambert-Eaton myasthenic syndrome. | *Lambert-Eaton myasthenic syndrome. | ||
=Microscopic= | ==Microscopic== | ||
Features: | Features: | ||
*Small cells -- typically 15-20 micrometers ~ 2x the size of [[RBC]]. | *Small cells -- typically 15-20 micrometers ~ 2x the size of [[RBC]]. | ||
| Line 36: | Line 38: | ||
DDx: | DDx: | ||
*[[ | *[[Endometrial stromal condensation]]. | ||
*Large cell [[lymphoma]]s, e.g. [[DLBCL]], [[ALCL]]. | |||
*[[Chloroma]]. | *[[Chloroma]]. | ||
*[[ | *[[Rhabdomyosarcoma]] - usu. [[CD56]] positive, may be keratin positive and positive for other [[neuroendocrine markers]].<ref name=pmid18487991>{{Cite journal | last1 = Bahrami | first1 = A. | last2 = Gown | first2 = AM. | last3 = Baird | first3 = GS. | last4 = Hicks | first4 = MJ. | last5 = Folpe | first5 = AL. | title = Aberrant expression of epithelial and neuroendocrine markers in alveolar rhabdomyosarcoma: a potentially serious diagnostic pitfall. | journal = Mod Pathol | volume = 21 | issue = 7 | pages = 795-806 | month = Jul | year = 2008 | doi = 10.1038/modpathol.2008.86 | PMID = 18487991 }}</ref> | ||
*[[Atypical lung carcinoid tumour]] (lung only). | |||
*[[Typical lung carcinoid tumour]] (lung only). | |||
*Other [[small round cell tumours]]. | |||
===Images=== | |||
====Cytology==== | |||
<gallery> | |||
Image:Small_cell_lung_cancer_-_cytology.jpg | Small cell carcinoma - cytology - Field stain. (WC) | |||
Image: Lung small cell carcinoma - Diff-Quik -- high mag.jpg | SmCC - Diff-Quik - high mag. (WC) | |||
Image: Lung small cell carcinoma - Diff-Quik -- very high mag.jpg | SmCC - Diff-Quik - very high mag. (WC) | |||
Image: Lung small cell carcinoma - Diff-Quik -- extremely high mag.jpg | SmCC - Diff-Quik - extremely high mag. (WC) | |||
Image: Lung small cell carcinoma -- very high mag.jpg | SmCC - Pap stain - very high mag. (WC) | |||
Image: Lung small cell carcinoma -- extremely high mag.jpg | SmCC - Pap stain - extremely high mag. (WC) | |||
</gallery> | |||
== | ====Metastatic==== | ||
<gallery> | <gallery> | ||
Image:Metastatic_small_cell_carcinoma_-_high_mag.jpg | Metastatic small cell carcinoma - high mag. (WC) | Image:Metastatic_small_cell_carcinoma_-_high_mag.jpg | Metastatic small cell carcinoma - high mag. (WC) | ||
Image:Metastatic_small_cell_carcinoma_-_very_high_mag.jpg | Metastatic small cell carcinoma - very high mag. (WC) | Image:Metastatic_small_cell_carcinoma_-_very_high_mag.jpg | Metastatic small cell carcinoma - very high mag. (WC) | ||
</gallery> | </gallery> | ||
====Small cell carcinoma in a lymph node==== | |||
<gallery> | |||
Image: Small cell carcinoma in lymph node -- low mag.jpg | Small cell carcinoma in a lymph node - low mag. (WC) | |||
Image: Small cell carcinoma in lymph node -- intermed mag.jpg | Small cell carcinoma in a lymph node - intermed. mag. (WC) | |||
Image: Small cell carcinoma in lymph node -- high mag.jpg | Small cell carcinoma in a lymph node - high mag. (WC) | |||
Image: Small cell carcinoma in lymph node -- very high mag.jpg | Small cell carcinoma in a lymph node - very high mag. (WC) | |||
</gallery> | |||
==IHC== | |||
*[[Neuroendocrine markers]] +ve - confirm the diagnosis. | |||
*IHC not particularity useful for determination of the primary site.<ref name=pmid17270664>{{Cite journal | last1 = Lobins | first1 = R. | last2 = Floyd | first2 = J. | title = Small cell carcinoma of unknown primary. | journal = Semin Oncol | volume = 34 | issue = 1 | pages = 39-42 | month = Feb | year = 2007 | doi = 10.1053/j.seminoncol.2006.10.027 | PMID = 17270664 }}</ref> ‡ | |||
Note: | |||
* | *‡ A CT chest should be done to assess for a lung tumour; fortunately, lung small cell carcinoma and extrapulmonary small cell cancer are treated similarily.<ref name=pmid20052730>{{Cite journal | last1 = Brennan | first1 = SM. | last2 = Gregory | first2 = DL. | last3 = Stillie | first3 = A. | last4 = Herschtal | first4 = A. | last5 = Mac Manus | first5 = M. | last6 = Ball | first6 = DL. | title = Should extrapulmonary small cell cancer be managed like small cell lung cancer? | journal = Cancer | volume = 116 | issue = 4 | pages = 888-95 | month = Feb | year = 2010 | doi = 10.1002/cncr.24858 | PMID = 20052730 }}</ref> | ||
=See also= | ==See also== | ||
*[[Lung tumours]]. | *[[Lung tumours]]. | ||
*[[Azzopardi phenomenon]]. | *[[Azzopardi phenomenon]]. | ||
| Line 58: | Line 83: | ||
*[[Neuroendocrine tumours]]. | *[[Neuroendocrine tumours]]. | ||
=References= | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Basics]] | [[Category:Basics]] | ||
Latest revision as of 13:12, 26 April 2016
Micrograph showing a small cell carcinoma.
Small cell carcinoma is a type of carcinoma. It is mostly commonly from the lung; 95% of cases are from the lung.[1]
It may be abbreviated SCC, leading to confusion with squamous cell carcinoma.
Overview
Grouping
May be grouped as:[1]
- Pulmonary.
- Gastrointestinal.
- Genitourinary.
- Small cell carcinoma of the prostate gland - most common small cell carcinoma outside of the lung.[2]
- Small cell carcinoma of the urinary bladder.
- Ovarian small cell carcinoma of the hypercalcemic type.
- Head & neck.
- Breast.
- Other.
Sites other than lung
General
Classic tumour with paraneoplastic syndromes - may be associated with:[7]
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH).
- Clinical: hyponatremia.
- Paraneoplastic cerebellar degeneration.
- Lambert-Eaton myasthenic syndrome.
Microscopic
Features:
- Small cells -- typically 15-20 micrometers ~ 2x the size of RBC.
- Scant cytoplasm.
- Stippled chromatin +/- smudging of the chromatin.
- +/-Nuclear moulding.
DDx:
- Endometrial stromal condensation.
- Large cell lymphomas, e.g. DLBCL, ALCL.
- Chloroma.
- Rhabdomyosarcoma - usu. CD56 positive, may be keratin positive and positive for other neuroendocrine markers.[8]
- Atypical lung carcinoid tumour (lung only).
- Typical lung carcinoid tumour (lung only).
- Other small round cell tumours.
Images
Cytology
Small cell carcinoma - cytology - Field stain. (WC)
SmCC - Diff-Quik - high mag. (WC)
SmCC - Diff-Quik - very high mag. (WC)
SmCC - Diff-Quik - extremely high mag. (WC)
SmCC - Pap stain - very high mag. (WC)
SmCC - Pap stain - extremely high mag. (WC)
Metastatic
Metastatic small cell carcinoma - high mag. (WC)
Metastatic small cell carcinoma - very high mag. (WC)
Small cell carcinoma in a lymph node
Small cell carcinoma in a lymph node - low mag. (WC)
Small cell carcinoma in a lymph node - intermed. mag. (WC)
Small cell carcinoma in a lymph node - high mag. (WC)
Small cell carcinoma in a lymph node - very high mag. (WC)
IHC
- Neuroendocrine markers +ve - confirm the diagnosis.
- IHC not particularity useful for determination of the primary site.[9] ‡
Note:
- ‡ A CT chest should be done to assess for a lung tumour; fortunately, lung small cell carcinoma and extrapulmonary small cell cancer are treated similarily.[10]
See also
- Lung tumours.
- Azzopardi phenomenon.
- Chloroma (AKA granulocytic sarcoma, myeloid sarcoma).
- Neuroendocrine tumours.
References
- ↑ 1.0 1.1 Grossman, RA.; Pedroso, FE.; Byrne, MM.; Koniaris, LG.; Misra, S. (May 2011). "Does surgery or radiation therapy impact survival for patients with extrapulmonary small cell cancers?". J Surg Oncol. doi:10.1002/jso.21976. PMID 21618245.
- ↑ Furtado, P.; Lima, MV.; Nogueira, C.; Franco, M.; Tavora, F. (2011). "Review of small cell carcinomas of the prostate.". Prostate Cancer 2011: 543272. doi:10.1155/2011/543272. PMID 22110988.
- ↑ Cesaretti, M.; Guarnieri, A.; Gaggelli, I.; Tirone, A.; Francioli, N.; Carli, AF.. "Small cell carcinoma of the breast. Report of a case.". Ann Ital Chir 82 (1): 61-4. PMID 21657157.
- ↑ Beach, DF.; Klump, WJ.; Haddad, G.; Reid, LM.; Schwarting, R.; Hageboutros, A. (Jun 2011). "Extrapulmonary small cell: a novel case of small cell carcinoma of the thyroid gland.". Med Oncol. doi:10.1007/s12032-011-9996-7. PMID 21644012.
- ↑ Morikawa, H.; Nakayama, Y.; Maeda, T.; Nadatani, Y.; Kobayashi, S.; Iwai, S.; Enomoto, M.; Tamori, A. et al. (Dec 2008). "A case of primary small cell carcinoma of the liver that was treated with chemotherapy.". Hepatol Int 2 (4): 500-4. doi:10.1007/s12072-008-9090-1. PMID 19669327.
- ↑ Choi, SJ.; Kim, JM.; Han, JY.; Ahn, SI.; Kim, JS.; Kim, L.; Park, IS.; Chu, YC. (Dec 2007). "Extrapulmonary small cell carcinoma of the liver: clinicopathological and immunohistochemical findings.". Yonsei Med J 48 (6): 1066-71. doi:10.3349/ymj.2007.48.6.1066. PMID 18159605.
- ↑ Sher, T.; Dy, GK.; Adjei, AA. (Mar 2008). "Small cell lung cancer.". Mayo Clin Proc 83 (3): 355-67. PMID 18316005.
- ↑ Bahrami, A.; Gown, AM.; Baird, GS.; Hicks, MJ.; Folpe, AL. (Jul 2008). "Aberrant expression of epithelial and neuroendocrine markers in alveolar rhabdomyosarcoma: a potentially serious diagnostic pitfall.". Mod Pathol 21 (7): 795-806. doi:10.1038/modpathol.2008.86. PMID 18487991.
- ↑ Lobins, R.; Floyd, J. (Feb 2007). "Small cell carcinoma of unknown primary.". Semin Oncol 34 (1): 39-42. doi:10.1053/j.seminoncol.2006.10.027. PMID 17270664.
- ↑ Brennan, SM.; Gregory, DL.; Stillie, A.; Herschtal, A.; Mac Manus, M.; Ball, DL. (Feb 2010). "Should extrapulmonary small cell cancer be managed like small cell lung cancer?". Cancer 116 (4): 888-95. doi:10.1002/cncr.24858. PMID 20052730.