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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]] | [[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/> | |||
It may be abbreviated '''[[SCC]]''', leading to confusion with [[squamous cell carcinoma]]. | |||
==Overview== | ==Overview== | ||
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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]]. | ||
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*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== | |||
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). | |||
**Clinical: hyponatremia. | |||
*Paraneoplastic cerebellar degeneration. | |||
*Lambert-Eaton myasthenic syndrome. | |||
==Microscopic== | ==Microscopic== | ||
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*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. | ||
DDx: | DDx: | ||
*[[ | *[[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> | |||
====Metastatic==== | |||
<gallery> | |||
Image:Metastatic_small_cell_carcinoma_-_high_mag.jpg | Metastatic small cell carcinoma - high mag. (WC) | |||
Image:Metastatic_small_cell_carcinoma_-_very_high_mag.jpg | Metastatic small cell carcinoma - very high mag. (WC) | |||
</gallery> | |||
====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> | |||
==IHC== | |||
*[[Neuroendocrine markers]] +ve - confirm the diagnosis. | |||
*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> ‡ | |||
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.<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> | |||
==See also== | ==See also== | ||
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*[[Azzopardi phenomenon]]. | *[[Azzopardi phenomenon]]. | ||
*[[Chloroma]] ([[AKA]] granulocytic sarcoma, myeloid sarcoma). | *[[Chloroma]] ([[AKA]] granulocytic sarcoma, myeloid sarcoma). | ||
*[[Neuroendocrine tumours]]. | |||
==References== | ==References== | ||