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

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| Gross      =
| Gross      =
| Grossing  =
| Grossing  =
| Site      =
| Site      = [[lung]] - see ''[[lung tumours]]''
| Assdx      =
| Assdx      =
| Syndromes  =
| Syndromes  =
| Clinicalhx = [[smoking]] - usually a long history, heavy
| Clinicalhx = [[smoking]] - usually a long history, heavy
| Signs      =
| Signs      = +/-hemoptysis
| Symptoms  =
| Symptoms  =
| Prevalence = not common
| Prevalence = not common
| Bloodwork  =
| Bloodwork  =
| Rads      =
| Rads      = lung mass, usu. central location
| Endoscopy  =
| Endoscopy  =
| Prognosis  = poor
| Prognosis  = poor
Line 45: Line 45:
Precursor lesion - uncommonly seen:
Precursor lesion - uncommonly seen:
*Pulmonary neuroendocrine cell hyperplasia.<ref name=pmid20943645>{{Cite journal  | last1 = Travis | first1 = WD. | title = Advances in neuroendocrine lung tumors. | journal = Ann Oncol | volume = 21 Suppl 7 | issue =  | pages = vii65-71 | month = Oct | year = 2010 | doi = 10.1093/annonc/mdq380 | PMID = 20943645 }}</ref>
*Pulmonary neuroendocrine cell hyperplasia.<ref name=pmid20943645>{{Cite journal  | last1 = Travis | first1 = WD. | title = Advances in neuroendocrine lung tumors. | journal = Ann Oncol | volume = 21 Suppl 7 | issue =  | pages = vii65-71 | month = Oct | year = 2010 | doi = 10.1093/annonc/mdq380 | PMID = 20943645 }}</ref>
Clinical:
*+/-Hemoptysis.


==Gross==
==Gross==

Revision as of 14:15, 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
Site lung - see lung tumours
Clinical history smoking - usually a long history, heavy
Signs +/-hemoptysis
Prevalence not common
Radiology lung mass, usu. central location
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]

Clinical:

  • +/-Hemoptysis.

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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