Large-cell lung carcinoma

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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[edit]

Pie 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 type.[1]

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.[2]

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.[3]

Diagnosis[edit]

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[edit]

The newest revisions of the World Health Organization (WHO) "Histological Typing of Lung Cancer schema" include several variants of LCLC, including:

Large-cell neuroendocrine carcinoma (LCNEC)[edit]

One clinically significant subtype is "large-cell neuroendocrine carcinoma" (LCNEC),[4] which is believed to derive from neuroendocrine cells.[5]

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.

Pathology images[edit]

Clinically[edit]

Patients typically present with a non-productive cough and weight loss.

References[edit]

  1. ^ Smokers defined as current or former smoker of more than 1 year of duration. See image page in Commons for percentages in numbers. Reference:
  2. ^ 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.  edit
  3. ^ 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. 
  4. ^ Fernandez FG, Battafarano RJ (October 2006). "Large-cell neuroendocrine carcinoma of the lung". Cancer Control 13 (4): 270–5. PMID 17075564. 
  5. ^ 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[edit]