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Difference between revisions of "Non-small cell lung carcinoma"
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Non-small cell lung carcinoma (view source)
Revision as of 04:25, 18 November 2015
, 04:25, 18 November 2015merge content from 'poorly differentiated carcinoma of the lung'
(merge content from 'poorly differentiated carcinoma of the lung') |
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In the clinical context, it is usually referred to as '''non-small cell lung cancer'''; this ignores the fact that not all non-small cell lung cancer fits into the carcinoma category. | In the clinical context, it is usually referred to as '''non-small cell lung cancer'''; this ignores the fact that not all non-small cell lung cancer fits into the carcinoma category. | ||
''Poorly differentiated carcinoma of the lung'' and ''poorly differentiated lung carcinoma'' redirect to this article. | |||
==General== | ==General== | ||
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**It is preferable to be more specific if this is possible, i.e. call ''adenocarcinoma'' or ''squamous cell carcinoma''. | **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. | *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. | ||
*''Small cell carcinoma'' is typically considered non-surgical disease; thus, ''non-small cell carcinoma'' or ''poorly differentiated carcinoma'', as a diagnosis, is less likely to exclude surgery as an option. | |||
Clinical: | |||
*Radiologic findings should not be suggestive of a metastasis. | |||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
* | *Typically large cells with abundant cytoplasm. | ||
*+/-[[Nucleoli]]. | *+/-[[Nucleoli]]. | ||
*No stippled chromatin. | *No stippled chromatin. | ||
DDx: | DDx: | ||
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*[[Small cell carcinoma of the lung]]. | *[[Small cell carcinoma of the lung]]. | ||
*Large cell variant of [[small cell carcinoma of the lung]]. | *Large cell variant of [[small cell carcinoma of the lung]]. | ||
*[[Lung metastasis]] - imaging suggestive of a metastasis or a history of malignancy. | |||
==IHC== | ==IHC== | ||
*Lack of staining with [[neuroendocrine markers]] (chromogranin A -ve, synaptophysin -ve, CD56 -ve). | |||
*Keratins +ve. | |||
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> | 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" | {| class="wikitable sortable" | ||
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| Squamous carcinoma | | Squamous carcinoma | ||
|} | |} | ||
==Sign out== | |||
<pre> | |||
Lung, Left Lower Lobe, Core Biopsy: | |||
- POORLY DIFFERENTIATED CARCINOMA, see comment. | |||
COMMENT: | |||
The tumour stains as follows: | |||
POSITIVE: EMA, AE1/AE3. | |||
NEGATIVE: TTF-1, chromogranin A, synaptophysin, CD56, CD45, CK5/6, p63. | |||
The morphology would be compatible with small cell carcinoma or basaloid | |||
squamous cell carcinoma. | |||
The neuroendocrine markers (chromogranin A, synaptophysin, CD56) and the squamoid | |||
markers available (p63, CK5/6) are negative; thus, the tumour is not further classified. | |||
</pre> | |||
==See also== | ==See also== | ||
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[[Category:Pulmonary pathology]] | [[Category:Pulmonary pathology]] | ||
[[Category:Diagnosis]] | |||