After your lung cancer is diagnosed, the doctor will run tests to find out the size of the tumor and whether the cancer has spread to other parts of the body. This process is called staging. Knowing the stage of your disease is crucial because it will help you and your doctor choose the best course of treatment.
Here’s a look at the options for each stage. Keep in mind that no one can say for sure how your cancer will respond. Every person is different, and so is every cancer. Your doctor will make...
High-grade neuroendocrine tumors including large-cell neuroendocrine carcinoma (LCNEC) and SCLC.
Because of differences in clinical behavior, therapy, and epidemiology, these tumors are classified separately in the World Health Organization (WHO) revised classification. The variant form of SCLC called mixed small cell/large cell carcinoma was not retained in the revised WHO classification. Instead, SCLC is now described with only one variant, SCLC combined, when at least 10% of the tumor bulk is made of an associated non-small cell component.
SCLC presents as a proliferation of small cells with the following morphological features:
Finely granular "salt and pepper" chromatin.
Absent or inconspicuous nucleoli.
Frequent nuclear molding.
A high mitotic count.
Combined small cell carcinoma includes a mixture of small cell and large cell or any other non-small cell component. Any cases showing at least 10% of SCLC are diagnosed as combined SCLC, and SCLC is limited to tumors with pure SCLC histology. SCLC associated with LCNEC is diagnosed as SCLC combined with LCNEC.
Nearly all SCLC are immunoreactive for keratin, thyroid transcription factor 1, and epithelial membrane antigen. Neuroendocrine and neural differentiation result in the expression of dopa decarboxylase, calcitonin, neuron-specific enolase, chromogranin A, CD56 (also known as nucleosomal histone kinase 1 or neural-cell adhesion molecule), gastrin-releasing peptide, and insulin-like growth factor 1. One or more markers of neuroendocrine differentiation can be found in approximately 75% of SCLC.
Although preinvasive and in situ malignant changes are frequently found in patients with non-small cell lung cancer, these findings are rare in patients with SCLC.
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Brambilla E, Travis WD, Colby TV, et al.: The new World Health Organization classification of lung tumours. Eur Respir J 18 (6): 1059-68, 2001.
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Kumar V, Abbas A, Fausto N, eds.: Robins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia, Pa: Elsevier Inc, 2005.
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WebMD Public Information from the National Cancer Institute
May 28, 2015
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