Difference between revisions of "Small cell carcinoma"

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'''Small cell carcinoma''' is a type of carcinoma.  It is mostly commonly from the [[lung tumours|lung]] ~95% of cases.<ref name=pmid21618245/>
[[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/>


=Overview=
It may be abbreviated '''[[SCC]]''', leading to confusion with [[squamous cell carcinoma]].
 
==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>
*[[Lung|Pulmonary]].
*[[Lung|Pulmonary]].
**[[Small cell carcinoma of the lung]].
*[[GI pathology|Gastrointestinal]].
*[[GI pathology|Gastrointestinal]].
*[[GU pathology|Genitourinary]].
*[[GU pathology|Genitourinary]].
**[[Small cell carcinoma of the prostate gland]] - most common small cell carcinoma outside of the lung.<ref name=pmid22110988>{{Cite journal  | last1 = Furtado | first1 = P. | last2 = Lima | first2 = MV. | last3 = Nogueira | first3 = C. | last4 = Franco | first4 = M. | last5 = Tavora | first5 = F. | title = Review of small cell carcinomas of the prostate. | journal = Prostate Cancer | volume = 2011 | issue =  | pages = 543272 | month =  | year = 2011 | doi = 10.1155/2011/543272 | PMID = 22110988 }}</ref>
**[[Small cell carcinoma of the urinary bladder]].
**[[Ovarian small cell carcinoma of the hypercalcemic type]].
*[[Head & neck pathology|Head & neck]].
*[[Head & neck pathology|Head & neck]].
*[[Breast]].
*[[Breast]].
Line 14: 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 22: 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]].
*Scant cytoplasm.
*Scant cytoplasm.
*Stippled chromatin.
*Stippled chromatin +/- smudging of the chromatin.
*+/-Nuclear moulding.
*+/-Nuclear moulding.
Images:
*[http://commons.wikimedia.org/wiki/File:Small_cell_lung_cancer_-_cytology.jpg Small cell carcinoma - cytology (WC)].
*[http://commons.wikimedia.org/wiki/File:Metastatic_small_cell_carcinoma_-_high_mag.jpg Metastatic small cell carcinoma - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Metastatic_small_cell_carcinoma_-_very_high_mag.jpg Metastatic small cell carcinoma - very high mag. (WC)].


DDx:
DDx:
*[[Small round cell tumours]].
*[[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>


=Special types=
====Metastatic====
==Ovarian small cell carcinoma of the hypercalcemic type==
<gallery>
*[[AKA]] ''small cell carcinoma, hypercalcemic type'', [[AKA]] ''small cell carcinoma of the ovary, hypercalcemic type''.
Image:Metastatic_small_cell_carcinoma_-_high_mag.jpg | Metastatic small cell carcinoma - high mag. (WC)
===General===
Image:Metastatic_small_cell_carcinoma_-_very_high_mag.jpg | Metastatic small cell carcinoma - very high mag. (WC)
*Hypercalcemia.<ref name=pmid7943531>{{Cite journal  | last1 = Young | first1 = RH. | last2 = Oliva | first2 = E. | last3 = Scully | first3 = RE. | title = Small cell carcinoma of the ovary, hypercalcemic type. A clinicopathological analysis of 150 cases. | journal = Am J Surg Pathol | volume = 18 | issue = 11 | pages = 1102-16 | month = Nov | year = 1994 | doi =  | PMID = 7943531 }}</ref>
</gallery>
*Rare.
====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>


===Microscopic===
==IHC==
Features:<ref name=pmid7943531/>
*[[Neuroendocrine markers]] +ve - confirm the diagnosis.
*Small cell carcinoma.
*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> ‡
*Follicle-like spaces.


Images:
Note:
*[http://webpathology.com/image.asp?n=6&Case=531 OSSCHT - low mag. (webpathology.com)].
*‡ 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>
*[http://webpathology.com/image.asp?case=531&n=5 OSSCHT - high mag. (webpathology.com)].


=See also=
==See also==
*[[Lung tumours]].
*[[Lung tumours]].
*[[Azzopardi phenomenon]].
*[[Azzopardi phenomenon]].
*[[Chloroma]] ([[AKA]] granulocytic sarcoma, myeloid sarcoma).
*[[Chloroma]] ([[AKA]] granulocytic sarcoma, myeloid sarcoma).
*[[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]

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:

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

References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ Sher, T.; Dy, GK.; Adjei, AA. (Mar 2008). "Small cell lung cancer.". Mayo Clin Proc 83 (3): 355-67. PMID 18316005.
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ 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.
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