Part 10C: Histopathology of small cell lung cancer

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Presentation transcript:

Part 10C: Histopathology of small cell lung cancer BRONCHATLAS© Prepared By www.Bronchoscopy.org

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Classification of Lung Tumors The most recent classification of the World Health Organization has gained wide acceptance. Several histological variant of each type of lung cancer are described. Major categories include : Squamous cell carcinoma 25% to 40% Adenocarcinoma 25% to 40% Small cell carcinoma 20% to 25% Large cell carcinoma 10% to 15% The incidence of adenocarcinoma has increased significantly in the last two decade; it is now the most common form of lung cancer in women and, in many studies, men as well.

Small Cell Carcinoma Epithelial cells are small with scant cytoplasm, ill-defined cell borders, finely granular nuclear chromatin (salt and pepper pattern), and absent or inconspicuous nucleoli . The cells are round, oval, and spindle-shaped with nuclear molding, high mitoses & necrosis. Basophilic staining of vascular walls due to encrustation by DNA from necrotic tumor cells is frequently present .

Small cell carcinoma Electron microscopy shows dense-core neurosecretory granules. Immunohistochemical stains for neuroendocrine markers such as chromogranin, synaptophysin ,and leu-7 are positive in most cases. Commonly associated with ectopic hormone production. Strong relationship with cigarette smoking. Most aggressive of lung tumors, metastasize widely, and are virtually incurable by surgical means.

Bronchoscopic appearances of Small Cell Carcinoma Tumors may be infiltrating, nodular, and obstructive

Bronchoscopic appearances of small cell carcinoma Thickened membranous portion of posterior membrane with prominent mucosal folds

Bronchoscopic appearances of Small Cell Carcinoma Segmental Subcarinal Nodular infiltration appearance involvement

Small Cell Carcinoma with nuclear molding High nucleus to cytoplasm ratio & nuclear moulding Hematoxylin- Eosin stain

Small Cell Carcinoma Dark blue cells with minimal cytoplasm are packed together in sheets Hemotoxylin- Eosin stain

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