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| Large Cell Carcinoma |
| Etiology • Associated with cigarette smoking • Radiation, air pollution and genetic predisposition may also play a role |
| Pathogenesis • BPDE (catabolite of benzo[a]pyrene in cigarette smoke) binds p53 mutational hot spots in lung carcinoma • p53 mutation affects cell replication and centromere replication, |
| Epidemiology • More frequent in males • Diagnosis of exclusion so that percentages of overall lung neoplasms that are large cell type varies widely between series |
| General Gross Description • Large, fleshy, gray-tan neoplasm |
| General Microscopic Description • Large cells with round to oval nuclei, prominent nucleoli and hyperchromasia • Mucin negative by mucicarmine staining • No intercellular bridges seen • Ultrastructural evidence may support diagnosis of either adenocarcinoma or squamous carcinoma |
| Clinical Correlation • Staging dependent on extent of disease ranging from I (confined to the lung with >2 cm distance from hilum and pleura) to IV (metastatic disease) • Metastatic disease to lymph nodes, brain, liver and adrenal glands • Surgical treatment is preferred; as many patients have insufficient pulmonary reserve for surgery, radiation is an alternative • Survival comparable to adenocarcinoma |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 720-25. |
| Large Cell Carcinoma |
| Synopsis by: Melinda Sanders M.D. (T28000M80123)[436] |
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