Non-small cell lung carcinoma
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Non-small cell lung carcinoma, abbreviated NSCLC, is a malignant epithelial neoplasm of the lung that is not small cell carcinoma of the lung.
It can be understood as a synonym for large cell carcinoma which is umbrella term that includes squamous cell carcinoma of lung and adenocarcinoma of the lung.
General
- Non-small cell lung carcinoma can be considered a waffle diagnosis and as such its use should be limited.
- It is preferable to be more specific if this is possible, i.e. call adenocarcinoma or squamous cell carcinoma.
- Historically, it was sufficient to differentiate between small cell and non-small cell carcinomas, as the treatment for all non-small cell lung carcinomas was the same.
Microscopic
Features:
- Large cells with abundant cytoplasm.
- +/-Nucleoli.
- No stippled chromatin.
- This suggests the large cell variant of small cell carcinoma.
DDx:
- Squamous cell carcinoma of the lung.
- Adenocarcinoma of the lung.
- Small cell carcinoma of the lung.
- Large cell variant of small cell carcinoma of the lung.
IHC
Sloan-Kettering algorithm - Rekhtman et al.:[1]
| TTF-1\p63 | p63 -ve (0% of cells) | p63 +ve <50% of cells | p63 +ve >=50% of cells |
|---|---|---|---|
| TTF-1 +ve >=50% of cells | Adenocarcinoma | Adenocarcinoma | Adenocarcinoma |
| TTF-1 +ve <50% of cells | Adenocarcinoma | Adenocarcinoma | Squamous carcinoma |
| TTF-1 -ve (0% of cells) | Adenocarcinoma | CK5/6 to determine | Squamous carcinoma |
See also
References
- ↑ Rekhtman, N.; Ang, DC.; Sima, CS.; Travis, WD.; Moreira, AL. (Oct 2011). "Immunohistochemical algorithm for differentiation of lung adenocarcinoma and squamous cell carcinoma based on large series of whole-tissue sections with validation in small specimens.". Mod Pathol 24 (10): 1348-59. doi:10.1038/modpathol.2011.92. PMID 21623384.