Large-cell lung carcinoma
|Large-cell lung carcinoma|
|Classification and external resources|
Large-cell lung carcinoma (LCLC) is a heterogeneous group of undifferentiated malignant neoplasms originating from transformed epithelial cells in the lung.
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.
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.
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.
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)
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:
- 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.