Small cell carcinoma of lungs

Small cell carcinoma of lungs 

Updated: 10/15/2020

© Jun Wang, MD, PhD

General features
  • Also called oat cell carcinoma
  • Poorly differentiated neuroendocrine tumor
  • Derived from primitive cells of basal bronchial epithelium
  • More common in men, median age 60
  • Strong association with tobacco smoking
  • Most common lung cancer associated with uranium mining, probably associated with radon
  • Smoking cessation associated with improved survival
Key clinical features
  • Nonspecific presentations similar to other lung cancer: cough, dyspnea, etc
  • Associated paraneoplastic syndromes due to production of ACTH, ADH, calcitonin, etc
  • Lambert-Eaton myasthenic syndrome
Presynaptic disorder of neuromuscular transmission
Autoimmune process against voltage-gated calcium channels (VGCCs)
Occasionally antibodies against acetylcholine receptor, but usually low titers (High titer seen in myasthenia gravis)
Impaired release of acetylcholine
Presentations: Proximal muscle weakness, depressed tendon reflexes, posttetanic potentiation, and autonomic changes
  • Acanthosis nigricans: Brown, velvety and verrucous plaques in axillae, back of neck and other skin folds, associated with visceral malignancies, endocrine diseases and congenital disorders
  • Leukemoidreactions: Reactive leukocytosis due to tumor produced bioactive factors
  • Trousseau syndrome: Acquired blood clotting disorder that results in migratory thrombophlebitis, commonly associated with internal malignancy, probably due to cancer caused imbalance of coagulative system
  • Hypertrophic pulmonary osteoarthropathy: Syndrome of clubbing of the digits, periostitis of the long (tubular) bones, and arthritis, probably associated with tumor released cytokine, growth factor, etc
Key morphological features
Markers
  • Positive: Cytokeratin, TTF1
  • Positive for neuroendocrine markers: CD56, neuron specific enolase, chromogranin, synaptophysin
  • Negative: CD45 and other lymphocytic markers
Treatment
  • Chemotherapy
  • Radiation therapy
Indicators for poor prognosis
  • Elevated serum LDH/alkaline phosphatase
  • Relapsed disease
  • Weight loss of greater than 10% of baseline body weight
  • Poor performance status
  • Hyponatremia



Back to malignant lung tumors
Back to respiratory tract neoplasms
Back to contents

Comments

Post a Comment

Popular posts from this blog

Contents

Pathology notes Jun Wang, MD, PhD 1. General information Frequently discussed syndromes Terms of dermatology Terms of hematology 2. Primary immunodeficiency disorders 3. Hemodynamic abnormalities Shock Thrombosis and embolism Bleeding disorders 4.  Benign blood cell disorders Anemia Benign white cell disorders 5. Hematopoietic neoplasms Lymphoid neoplasms Myeloid neoplasms Histiocytic neoplasms: Langerhans cell histiocytosis 6. Cardiovascular system Pulmonary hypertension Cardiovascular system tumors 7. Respiratory tract tumors 8. Gastrointestinal tract Congenital disorders Infectious gastroenteritis Oral cavity Esophagus Stomach Intestinal tumors Salivary glands Exocrine pancreas and gallbladder 9. Urinary system Kidney masses Lower urinary tract 10. Male reproductive system 11. Female genital tract 12. Breast 13. Endocrine organs Pituitary gland Adrenal gland Thyroid gland Parathyroid gland Endocrine pancreas M
Read more

Anemia

Anemia Updated: 07/13/2024 © Jun Wang, MD, PhD   General features Decrease in red cell mass Hemoglobin: Levels of hemoglobin in a specific volume of whole blood Hematocrit: Fraction of whole blood composed of red blood cells Red cell count: Quantity of red cell in a specific volume of whole blood Three major groups based on RBC sizes Microcytic Normocytic Macrocytic Three major causes Blood loss: acute or chronic Increased red cell destruction: hemolysis Reduced production: marrow failure due to genetic abnormality or nutritional deficiency Etiology Genetic abnormality Hemoglobinopathies RBC cytoskeletal abomorlities Enzyme abnormalities Fanconi anemia Nutritional deficiencies: iron, VB12, folate, general malnutrition Physical etiologies: trauma, burns, frostbite, prosthetic valves, etc Chronic diseases: chronic infections, neoplasia, autoimmune disorders, kidney or liver diseases, etc Infectious diseases: hepatitis, sepsis , malaria, etc
Read more

Lymphoid neoplasms

Lymphocytic neoplasms Updated: 05/17/2020 © Jun Wang, MD, PhD Terminology Lymphoma : Proliferations forming discrete tissue masses Leukemia : Widespread involvement of the bone marrow and usually the peripheral blood Any "lymphoma" can present with or evolve to a leukemic picture, and any "leukemia" can occasionally present with a mass lesion Other hematology terms Important risk factors Immunodeficiency (primary or secondary) Autoimmune disorders Viruses (HIV, KSHV/HHV8, HTLV-1) H. pylori infection Radiation Chemotherapy Diagnostic approaches Complete history, especially those with possible epidemic characters, such as Burkitt lymphoma CBC, Bone marrow Morphology/immunohistochemistry Immunofluorescence flow cytometry Cytogenetic studies Molecular studies Commonly used markers All lymphomas: CD45 B-cell neoplasms: CD5, CD10, CD19, CD20, CD79a, CD23, bcl2, bcl6, cyclin D1, light chai
Read more