Large-cell lung carcinoma
| Large-cell lung carcinoma | |
|---|---|
| Classification and external resources | |
| ICD-O: | M8012/3 |
| MeSH | D018287 |
Large-cell lung carcinoma (LCLC) is a heterogeneous group of undifferentiated malignant neoplasms originating from transformed epithelial cells in the lung.
Incidence
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 2.3 compared to never-smokers, and a duration of more than 40 years giving a relative risk of approximately 3.6.[1]
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 37.0 in men and 72.9 in women.[2]
Diagnosis
LCLC 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.
LCLC 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.
Classification
The newest revisions of the World Health Organization (WHO) "Histological Typing of Lung Cancer schema" include several variants of LCLC, 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 (LCNEC)
One clinically significant subtype is "large-cell neuroendocrine carcinoma" (LCNEC),[3] which is believed to derive from neuroendocrine cells.[4]
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.
Clinically
Patients typically present with a non-productive cough and weight loss.
References
- ↑ 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. doi:10.1136/tc.2007.022582. PMC 3044470. PMID 18390646.
- ↑ 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 : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 6 (7): 477–80. PMID 9232332.
- ↑ Fernandez FG, Battafarano RJ (October 2006). "Large-cell neuroendocrine carcinoma of the lung". 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.
External links
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