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An introduction to lung pathology is found in the ''[[pulmonary pathology]]'' article. | An introduction to lung pathology is found in the ''[[pulmonary pathology]]'' article. | ||
=Lung tumours overview= | |||
===Schematic overview of lung cancer (clinical)=== | ===Schematic overview of lung cancer (clinical)=== | ||
{{familytree/start}} | {{familytree/start}} | ||
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**Image: [http://commons.wikimedia.org/w/index.php?title=File:Lung_adenocarcinoma_-_TTF-1_-_high_mag.jpg Nuclear staining with TTF-1 in a metastatic lung adenocarcinoma (WC)]. | **Image: [http://commons.wikimedia.org/w/index.php?title=File:Lung_adenocarcinoma_-_TTF-1_-_high_mag.jpg Nuclear staining with TTF-1 in a metastatic lung adenocarcinoma (WC)]. | ||
==Neuroendocrine tumours== | |||
===Overview=== | |||
*This is a group of tumours that has benign (e.g. [[carcinoid]] tumour of the lung) to malignant (e.g. small cell lung carcinoma) behaviour.<ref>URL: [http://emedicine.medscape.com/article/426400-overview http://emedicine.medscape.com/article/426400-overview]. Accessed on: 20 January 2010.</ref> | |||
*They are thought to arise from [[pulmonary neuroendocrine cell]]s.<ref>{{cite journal |author=Chong S, Lee KS, Chung MJ, Han J, Kwon OJ, Kim TS |title=Neuroendocrine tumors of the lung: clinical, pathologic, and imaging findings |journal=Radiographics |volume=26 |issue=1 |pages=41–57; discussion 57–8 |year=2006 |pmid=16418242 |doi=10.1148/rg.261055057 |url=}}</ref> | |||
===Classification=== | |||
The grouping can be divided into four types:<ref name=cancerorg_car>URL: [http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_lung_carcinoid_tumor_56.asp http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_lung_carcinoid_tumor_56.asp]. Accessed on: 16 February 2011.</ref> | |||
*Small cell carcinoma. | |||
*Large cell neuroendocrine carcinoma. | |||
*Typical carcinoid. | |||
*Atypical carcinoid. | |||
===Cytologic features=== | |||
Cytologic features useful for differentiation: | |||
*Small cell carcinoma: necrosis, scant cytoplasm, mitoses. | |||
*Typical carcinoid: often more cytoplasm, no necrosis, low mitotic rate (MIB-1: scant staining). | |||
*Atypical carcinoid: higher mitotic rate/MIB-1 than ''typical carcinoid'',<ref>WG. February 2010.</ref> no necrosis. | |||
Notes:<ref name=cancerorg_car/> | |||
*''Large cell'' and ''small cell'' tumours behave in a similar fashion; ''large cell'' can be considered a morphological variant of ''small cell''. | |||
*9/10 of carcinoids are ''typical'' and usually have a good prognosis, i.e. do not metastasize. | |||
**Central location (vis-a-vis peripheral location) tends favours ''typical carcinoid'' over ''atypical carcinoid''. | |||
=Specific types= | |||
==Lung adenocarcinoma== | ==Lung adenocarcinoma== | ||
===General=== | ===General=== | ||
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#*Subtypes: micropapillary, mucinous (previously ''mucinous BAC'', colloid, fetal, enteric. | #*Subtypes: micropapillary, mucinous (previously ''mucinous BAC'', colloid, fetal, enteric. | ||
== | ==Typical carcinoid lung tumour== | ||
=== | *[[AKA]] ''carcinoid of the lung''. | ||
* | ===General=== | ||
*Approximately 80% of lung carcinoids.<ref name=pmid20888248>{{Cite journal | last1 = Naalsund | first1 = A. | last2 = Rostad | first2 = H. | last3 = Strøm | first3 = EH. | last4 = Lund | first4 = MB. | last5 = Strand | first5 = TE. | title = Carcinoid lung tumors--incidence, treatment and outcomes: a population-based study. | journal = Eur J Cardiothorac Surg | volume = 39 | issue = 4 | pages = 565-9 | month = Apr | year = 2011 | doi = 10.1016/j.ejcts.2010.08.036 | PMID = 20888248 }}</ref> | |||
=== | ===Microscopic=== | ||
Features: | |||
* | *Nests of cells. | ||
* | **Stippled chromatin. | ||
* | **Moderate cytoplasm. | ||
* | *No necrosis. | ||
*Low mitotic rate. | |||
=== | ===IHC=== | ||
MIB-1 scant staining. | |||
==Malignant mesothelioma== | ==Malignant mesothelioma== |
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