Pathology of small-cell lung cancer.
The morphological differentiation between small-cell and non-small-cell lung cancer has great prognostic and therapeutic significance for the patient. Malignant lung tumors are now classified according to the new 1999 WHO/IASLC classification of lung and pleural tumors. The variant of heterogeneously differentiated "combined small-cell carcinoma" can be distinguished from classical small-cell carcinoma, whereas the subtype of "intermediate cell carcinoma" is no longer used. Together with "large-cell neuroendocrine carcinomas" and typical or atypical carcinoid tumors, small-cell lung cancers are currently histogenetically categorized as neuroendocrine lung tumors. In contrast to large-cell neuroendocrine carcinoma, the immunohistochemical demonstration of neuroendocrine differentiation is not a prerequisite for the diagnosis of small-cell lung cancer. Although electron-microscopical, immunohistochemical, and molecular-biological findings have considerably increased our understanding of the pathogenesis and progression of malignant lung tumors, routine pathological-anatomical diagnostics are still decisively based on light-microscopical evaluation of tissue samples.
Institute of Pathology, Bergmannsheil University Hospital, Ruhr University of Bochum, Germany. patho-bhl@ruhr-uni-bochum.de
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D018288:Carcinoma, Small Cell / Q000453:epidemiology / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D015972:Gene Expression Regulation, Neoplastic; D016147:Genes, Tumor Suppressor / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D008854:Microscopy, Electron; D009154:Mutation; D009857:Oncogenes / Q000235:genetics; D012074:Remission Induction; D015854:Up-Regulation