Large-cell lung carcinomalarge cell lung carcinoma, poorly differentiated large cell lung carcinoma
Large-cell carcinoma LCC is a heterogeneous group of undifferentiated malignant neoplasms that lack the cytologic and architectural features of small cell carcinoma and glandular or squamous differentiation LCC is categorized as a type of NSCLC Non-Small Cell Carcinoma which originates from epithelial cells of the lung1
- 1 Incidence
- 2 Diagnosis
- 3 Classification
- 31 Large-cell neuroendocrine carcinoma LCNEC
- 32 Pathology images
- 4 Clinically
- 5 References
- 6 External links
IncidenceeditPie chart showing incidence of large-cell lung cancer shown in green at upper left as compared to other lung cancer types, with fractions of smokers versus non-smokers shown for each type1
In most series, LCLC's comprise between 5% and 10% of all lung cancers
According to the Nurses' Health Study, the risk of large cell lung carcinoma increases with a previous history of tobacco smoking, with a previous smoking duration of 30 to 40 years giving a relative risk of approximately 23 compared to never-smokers, and a duration of more than 40 years giving a relative risk of approximately 362
Another study concluded that cigarette smoking is the predominant cause of large cell lung cancer It estimated that the odds ratio associated with smoking two or more packs/day for current smokers is 370 in men and 729 in women3
LCC is, in effect, a "diagnosis of exclusion", in that the tumor cells lack light microscopic characteristics that would classify the neoplasm as a small-cell carcinoma, squamous-cell carcinoma, adenocarcinoma, or other more specific histologic type of lung cancer
LCC is differentiated from small-cell lung carcinoma SCLC primarily by the larger size of the anaplastic cells, a higher cytoplasmic-to-nuclear size ratio, and a lack of "salt-and-pepper" chromatin
The newest revisions of the World Health Organization WHO "Histological Typing of Lung Cancer schema" include several variants of LCC, including:
- Giant-cell carcinoma of the lung
- Basaloid large cell carcinoma of the lung
- Clear cell carcinoma of the lung
- Lymphoepithelioma-like carcinoma of the lung
- Large-cell lung carcinoma with rhabdoid phenotype
- Large cell neuroendocrine carcinoma of the lung
Large-cell neuroendocrine carcinoma LCNECedit
One clinically significant subtype is "large-cell neuroendocrine carcinoma" LCNEC,4 which is believed to derive from neuroendocrine cells5
In addition, a "subvariant", called "combined large-cell neuroendocrine carcinoma" or c-LCNEC, is recognized under the new system To be designated a c-LCNEC, the tumor must contain at least 10% LCNEC cells, in combination with at least 10% of other forms of NSCLC
Patients typically present with a non-productive cough and weight loss
- ^ Smokers defined as current or former smoker of more than 1 year of duration See image page in Commons for percentages in numbers Reference:
- Table 2 in: Kenfield SA, Wei EK, Stampfer MJ, Rosner BA, Colditz GA 2008 "Comparison of aspects of smoking among the four histological types of lung cancer" Tob Control 17 3: 198–204 PMC 3044470 PMID 18390646 doi:101136/tc2007022582
- ^ Kenfield, S A; Wei, E K; Stampfer, M J; Rosner, B A; Colditz, G A 2008 "Comparison of aspects of smoking among the four histological types of lung cancer" Tobacco Control 17 3: 198–204 PMC 3044470 PMID 18390646 doi:101136/tc2007022582
- ^ Muscat, JE; Stellman, SD; Zhang, ZF; Neugut, AI; Wynder, EL July 1997 "Cigarette smoking and large cell carcinoma of the lung" Cancer Epidemiology, Biomarkers & Prevention 6 7: 477–80 PMID 9232332
- ^ Fernandez FG, Battafarano RJ October 2006 "Large-cell neuroendocrine carcinoma of the lung" PDF Cancer Control 13 4: 270–5 PMID 17075564
- ^ Cotran, Ramzi S; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L; Abbas, Abul K 2005 Robbins and Cotran pathologic basis of disease St Louis, Mo: Elsevier Saunders p 762 ISBN 0-7216-0187-1
- 1 World Health Organization Histological Classification of Lung and Pleural Tumours 4th Edition
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