Small cell carcinoma of the lung: Difference between revisions

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| Caption    = Lung small cell carcinoma. [[H&E stain]].
| 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, nuclei with smudgy appearance ([[Azzopardi phenomenon]]), 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  = histology: large cell neuroendocrine carcinoma (LCNEC); molecular subtypes: ASCL1, NEUROD1, POU2F3, YAP1
| Subtypes  = histology: large cell neuroendocrine carcinoma (LCNEC); molecular subtypes: ASCL1, NEUROD1, POU2F3, YAP1
| LMDDx      = poorly differentiated [[adenocarcinoma of the lung]], [[atypical carcinoid]], [[lung carcinoid]], metastatic [[small cell carcinoma]], [[lymphoma]], other [[small round blue cell tumours]]
| LMDDx      = poorly differentiated [[adenocarcinoma of the lung]], [[atypical carcinoid]], [[lung carcinoid]], metastatic [[small cell carcinoma]], [[lymphoma]], other [[small round blue cell tumours]] (e.g [[Ewing sarcoma]], [[NUT carcinoma]])
| Stains    =  
| Stains    =  
| IHC        = chromogranin +ve, synaptophysin +ve, CD56 +ve, NSE +ve, TTF-1 +ve, Ki-67 (>50%)
| IHC        = chromogranin +ve, synaptophysin +ve, CD56 +ve, NSE +ve, TTF-1 +ve, Ki-67 (>50%)
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===Molecular subtypes via IHC===
===Molecular subtypes via IHC===
Based on Chiang ''et al.'' in a cohort of 72 small cell carcinomas:<ref>{{cite journal |authors=Chiang CL, Huang HC, Luo YH, Shen CI, Chao HS, Tseng YH, Chou TY, Schrump DS, Yeh YC, Chen YM |title=Clinical utility of immunohistochemical subtyping in patients with small cell lung cancer |journal=Lung Cancer |volume=188 |issue= |pages=107473 |date=February 2024 |pmid=38232600 |doi=10.1016/j.lungcan.2024.107473 |url=}}</ref>
Based on Baine ''et al.'' in a cohort of ~170 cases:<ref name=pmid33011388>{{cite journal |authors=Baine MK, Hsieh MS, Lai WV, Egger JV, Jungbluth AA, Daneshbod Y, Beras A, Spencer R, Lopardo J, Bodd F, Montecalvo J, Sauter JL, Chang JC, Buonocore DJ, Travis WD, Sen T, Poirier JT, Rudin CM, Rekhtman N |title=SCLC Subtypes Defined by ASCL1, NEUROD1, POU2F3, and YAP1: A Comprehensive Immunohistochemical and Histopathologic Characterization |journal=J Thorac Oncol |volume=15 |issue=12 |pages=1823–1835 |date=December 2020 |pmid=33011388 |pmc=8362797 |doi=10.1016/j.jtho.2020.09.009 |url=}}</ref>
{| class="wikitable sortable"
!Type
!Prevalence
!Staining with IHC marker
|-
|ASCL1
| 55%
| 73%
|-
|NEUROD1
| 27%
| 63%
|-
|POU2F3
| 10%
| 15%
|-
|YAP1
| 0%
| 3%
|}
 
Based on Baine ''et al.'':<ref name=pmid33011388>{{cite journal |authors=Baine MK, Hsieh MS, Lai WV, Egger JV, Jungbluth AA, Daneshbod Y, Beras A, Spencer R, Lopardo J, Bodd F, Montecalvo J, Sauter JL, Chang JC, Buonocore DJ, Travis WD, Sen T, Poirier JT, Rudin CM, Rekhtman N |title=SCLC Subtypes Defined by ASCL1, NEUROD1, POU2F3, and YAP1: A Comprehensive Immunohistochemical and Histopathologic Characterization |journal=J Thorac Oncol |volume=15 |issue=12 |pages=1823–1835 |date=December 2020 |pmid=33011388 |pmc=8362797 |doi=10.1016/j.jtho.2020.09.009 |url=}}</ref>
{| class="wikitable sortable"  
{| class="wikitable sortable"  
! IHC grouping
! IHC grouping
! Prevalence
! Prevalence
! Other IHC
! Notes
! Notes
! Other IHC
|-
|-
|ASCL1+ / NeuroD1-
|ASCL1 +ve / NeuroD1 -ve
|41%
|41%
|TTF-1 +ve
|
|
|TTF1+
|-
|-
|ASCL1+ / NeuroD1+
|ASCL1 +ve / NeuroD1 +ve
|37%
|37%
|TTF-1 +ve
|
|
|TTF1+
|-
|-
|ASCL1- / NeuroD1+
|ASCL1 -ve / NeuroD1 +ve
|8%
|8%
|TTF-1 +ve
|
|
|TTF1+
|-
|-
|ASCL1- / NeuroD1-
|ASCL1 -ve / NeuroD1 -ve
|14%
|14%
|includes all POU2F3 cases which are ~9% of small cell carcinoma
|TTF-1 -ve
|TTF1-
|includes all POU2F3 +ve cases which are ~9% of small cell carcinoma
|}
|}


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