Difference between revisions of "Non-small cell lung cancer"

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#redirect [[Non-small cell lung carcinoma]]
'''Non-small cell [[lung]] cancer''', abbreviated '''NSCLC''', is a malignant neoplasm of the lung that is ''not'' [[small cell carcinoma of the lung]]. 
 
It can be understood as a synonym for '''large cell carcinoma''' and '''non-small cell lung carcinoma'''. It is umbrella term that includes [[squamous cell carcinoma of lung]], [[adenocarcinoma of the lung]] and [[adenosquamous carcinoma of the lung]].<ref>{{Cite journal  | last1 = Song | first1 = Z. | last2 = Lin | first2 = B. | last3 = Shao | first3 = L. | last4 = Zhang | first4 = Y. | title = Therapeutic efficacy of gefitinib and erlotinib in patients with advanced lung adenosquamous carcinoma. | journal = J Chin Med Assoc | volume = 76 | issue = 9 | pages = 481-5 | month = Sep | year = 2013 | doi = 10.1016/j.jcma.2013.05.007 | PMID = 23769878 }}</ref>
 
==General==
*''Non-small cell lung carcinoma'' can be considered a [[waffle diagnosis]] and as such its use should be limited.
**It is preferable to be more specific if this is possible, i.e. call ''adenocarcinoma'' or ''squamous cell carcinoma''.
*Historically, it was sufficient to differentiate between [[small cell carcinoma of the lung|small cell]] and non-small cell carcinomas, as the treatment for all non-small cell lung carcinomas was the same.
 
==Microscopic==
Features:
*Large cells with abundant cytoplasm.
*+/-[[Nucleoli]].
*No stippled chromatin.
**This suggests the ''large cell variant of small cell carcinoma''.
 
DDx:
*[[Squamous cell carcinoma of the lung]].
*[[Adenocarcinoma of the lung]].
*[[Small cell carcinoma of the lung]].
*Large cell variant of [[small cell carcinoma of the lung]].
 
==IHC==
Sloan-Kettering algorithm - Rekhtman ''et al.'':<ref name=pmid21623384>{{Cite journal  | last1 = Rekhtman | first1 = N. | last2 = Ang | first2 = DC. | last3 = Sima | first3 = CS. | last4 = Travis | first4 = WD. | last5 = Moreira | first5 = AL. | title = Immunohistochemical algorithm for differentiation of lung adenocarcinoma and squamous cell carcinoma based on large series of whole-tissue sections with validation in small specimens. | journal = Mod Pathol | volume = 24 | issue = 10 | pages = 1348-59 | month = Oct | year = 2011 | doi = 10.1038/modpathol.2011.92 | PMID = 21623384 }}</ref>
{| class="wikitable sortable"
! TTF-1\p63
! p63 -ve (0% of cells)
! p63 +ve <50% of cells
! p63 +ve >=50% of cells
|-
| TTF-1 +ve >=50% of cells
| Adenocarcinoma
| Adenocarcinoma
| Adenocarcinoma
|-
| TTF-1 +ve <50% of cells
| Adenocarcinoma
| Adenocarcinoma
| Squamous carcinoma
|-
| TTF-1 -ve (0% of cells)
| Adenocarcinoma
| CK5/6 to determine
| Squamous carcinoma
|}
 
==See also==
*[[Lung tumours]].
 
==References==
{{Reflist|1}}
 
[[Category:Pulmonary pathology]]

Revision as of 01:33, 9 April 2014

Non-small cell lung cancer, abbreviated NSCLC, is a malignant neoplasm of the lung that is not small cell carcinoma of the lung.

It can be understood as a synonym for large cell carcinoma and non-small cell lung carcinoma. It is umbrella term that includes squamous cell carcinoma of lung, adenocarcinoma of the lung and adenosquamous carcinoma of the lung.[1]

General

  • Non-small cell lung carcinoma can be considered a waffle diagnosis and as such its use should be limited.
    • It is preferable to be more specific if this is possible, i.e. call adenocarcinoma or squamous cell carcinoma.
  • Historically, it was sufficient to differentiate between small cell and non-small cell carcinomas, as the treatment for all non-small cell lung carcinomas was the same.

Microscopic

Features:

  • Large cells with abundant cytoplasm.
  • +/-Nucleoli.
  • No stippled chromatin.
    • This suggests the large cell variant of small cell carcinoma.

DDx:

IHC

Sloan-Kettering algorithm - Rekhtman et al.:[2]

TTF-1\p63 p63 -ve (0% of cells) p63 +ve <50% of cells p63 +ve >=50% of cells
TTF-1 +ve >=50% of cells Adenocarcinoma Adenocarcinoma Adenocarcinoma
TTF-1 +ve <50% of cells Adenocarcinoma Adenocarcinoma Squamous carcinoma
TTF-1 -ve (0% of cells) Adenocarcinoma CK5/6 to determine Squamous carcinoma

See also

References

  1. ↑ Song, Z.; Lin, B.; Shao, L.; Zhang, Y. (Sep 2013). "Therapeutic efficacy of gefitinib and erlotinib in patients with advanced lung adenosquamous carcinoma.". J Chin Med Assoc 76 (9): 481-5. doi:10.1016/j.jcma.2013.05.007. PMID 23769878.
  2. ↑ Rekhtman, N.; Ang, DC.; Sima, CS.; Travis, WD.; Moreira, AL. (Oct 2011). "Immunohistochemical algorithm for differentiation of lung adenocarcinoma and squamous cell carcinoma based on large series of whole-tissue sections with validation in small specimens.". Mod Pathol 24 (10): 1348-59. doi:10.1038/modpathol.2011.92. PMID 21623384.
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