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

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*[[typical carcinoid|Carcinoid]].
*[[typical carcinoid|Carcinoid]].
*[[atypical carcinoid|Atypical carcinoid]].
*[[atypical carcinoid|Atypical carcinoid]].
*Small cell carinoma/large cell neuroendocrine carcinoma.
*Small cell carinoma/large cell neuroendocrine carcinoma (LCNEC).
 
Note:
*LCNEC can be thought of the ''large cell variant of small cell carcinoma''.


Precursor lesion - uncommonly seen:
Precursor lesion - uncommonly seen:

Revision as of 17:13, 4 September 2015

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.

Small cell carcinoma in general is dealt with in the small cell carcinoma article.

General

  • Strong association with smoking.
  • Typically treated with chemotherapy.
  • Poor prognosis.

On a spectrum of lesions (benign to malignant):[1]

Note:

  • LCNEC can be thought of the large cell variant of small cell carcinoma.

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]
  • CK7 -ve.[3]
  • CK20 -ve.[3]

Sign out

Lung, Left Lower Lobe, Core Biopsy:
- SMALL CELL CARCINOMA.

Block letters

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.
  3. ↑ 3.0 3.1 Gyure, KA.; Morrison, AL. (Jun 2000). "Cytokeratin 7 and 20 expression in choroid plexus tumors: utility in differentiating these neoplasms from metastatic carcinomas.". Mod Pathol 13 (6): 638-43. doi:10.1038/modpathol.3880111. PMID 10874668.
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