Clinical applications of the pathological properties of small cell carcinoma, large cell carcinoma, and adenoid cystic carcinoma of the lung

Abstract

Lung cancer has considerable treatment problems, with a poor 5-yr survival rate after surgery. Application of histopathological and immunohistopathological subtyping have proven to be powerful tools for the assessment of prognosis. Results in 33 patients with small cell carcinoma, 44 with large cell carcinoma, and five with adenoid cystic carcinoma of the lung are discussed. The 5-yr survival rates in patients with small cell carcinoma of the oat cell type and intermediate type were 24 and 44%, respectively. Argyrophilic granules and neuron-specific enolase, neuroendocrine markers, were detected more frequently in the oat cell type rather than in the intermediate type. In contrast, keratin, epithelial membrane antigen, and carcinoembryonic antigen, epithelial origin markers, were present more frequently in the intermediate type than in the oat cell type. The 5-yr survival rates with large cell carcinoma of the compact growth type and the loose structure type were 46 and 28%, respectively, based on evidence of morphologically intercellular cohesion. The epithelial origin markers were detectable and more frequent in the compact growth type than in the loose structure type. The growth patterns of adenoid cystic carcinoma are classified as tubular, cribriform, and solid. The solid pattern was the most aggressive with extensive perineural invasion. We propose that the pathological properties of lung cancer should be examined as a prognostic implication of subtyping.

Primary adenoid cystic carcinoma of the lung: A clinicopathologic study

“…Extensive review of literature of ACC of lung has been carried out in the present study which showed that this tumour will not necessarily behave indolently and may occasionally follow a much more aggressive course than that generally ascribed to their salivary gland counterparts [6][7][8][9] . Some authors believe that histologic features (e.g., pattern of growth, cytologic atypia and mitotic activity) correlate with clinical behaviour of the lesions 10 . They highlighted that a predominantly tubular growth of ACC has a better prognosis than a tumour showing more solid growth pattern 10,11 .…”

“…Some authors believe that histologic features (e.g., pattern of growth, cytologic atypia and mitotic activity) correlate with clinical behaviour of the lesions 10 . They highlighted that a predominantly tubular growth of ACC has a better prognosis than a tumour showing more solid growth pattern 10,11 . Others support the observation that clinical staging (e.g., size of tumours, extent of spread and metastases) at the time of initial diagnosis may be most important predictor of prognosis of this tumour 9, 12 .…”

Left recurrent laryngeal nerve palsy associated with silicosis

“…In two of these cases, the diagnosis was also confirmed by mediastinoscopy and lymph node biopsy. In patient of this study, the mediastinoscopy was mainly performed to rule out malignancy, since some tumours grow along nerves without infiltration of other structures [5, 6]. Sarcoidosis was also considered in the present patient, since it has been reported as a rare cause of recurrent laryngeal nerve paralysis, either by granulomatous inflammation of the larynx, neuropathy of the vagus nerve, or by compression of the left recurrent laryngeal nerve by mediastinal lymph nodes [7–11].…”

Adenoid Cystic Carcinoma of the Lung

“…Affected patients are usually adults, with one study reporting patients ranging in age from 29 to 79 years (mean, 54 years), and with a fairly equal occurrence in men and women. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Adenoid cystic carcinoma of lung (ACCL) is usually centrally located in the trachea or proximal bronchi, and therefore patients typically present with signs and symptoms of bronchial obstruction or ulceration, including dyspnea, cough, wheezing, pneumonia, and/or hemoptysis. Peripherally located ACCL may be asymptomatic and is less common, 5,13 constituting only 10 to 15% of all ACCLs.…”