Histologies of Lung Cancer

COMPARISON OF LUNG CANCER HISTOLOGY (Line DH: Br J Dis Chest 65;238-242;1971) & others.

SCLC Adenocarcinoma Squamous cell Large Cell
Risk of brain metastasis 10-14% (presentation)
28-50% (autopsy)
19% (as initial site of failure)
40% (autopsy)
7% (as initial site of failure)
16% (autopsy)
13% (as initial site of failure)
34% (autopsy)
Overall incidence 20% 40% (most common type) 25% 10% (Least Common)
Typical Pathological Features Crush artifacts 90% have 3p deletion Glandular formation "tad-pole" shaped cells Keratin High nuclear to cytoplasmic ratio
Markers Neuron-specific enolase
L-dopa decarboxylase
Gastrin-releaseing peptide
CAM
EGFR mutation, ALK mutation; TTF1, CK7 CK5/6, p63
Location in Lung 80% are centrally located Peripheral Proximal bronchi
Risk factors/ Cells of origin Most strongly associated with smoking (rare for non-smokers) Majority of non-smokers are adenocarcinoma
Surface epithelium
bronchial mucosal glands
peripheral scar tumors (infection, sarcoid ect. not smoking)
squamous metaplasia
CIS
Neuroendocrine
Para-neoplastic SIADH (exclusively w/ SCLC)
Lambert-eaton (exclusively w/ SCLC)
Hypertrophic pulmonary osteoarthropathy Hypercalcemia Gynecomastia

Bronchoalveolar

  • (not prone to spread early) is a subtype from type II pneumocytes
  • presents as a solitary nodule, multifocal disease, and progressive form to spread from lobe to lobe.
  • It has an increased association with asbestos.
  • is not associated with smoking (associated with prior lung disease)

Carcinoid (rare) is found in endobronchial areas and rarely metastasize.

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