Squamous cell carcinoma of the lung pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
Squamous cell carcinoma of the lung arises from the [[epithelial]] cells of the lung of the central [[bronchi]] to terminal [[alveoli]], which are normally involved in the protection of the airways. Squamous cell carcinoma of the lung has a central location, and usually appears as a hiliar or perihiliar mass. Squamous cell carcinoma of the lung is a rapidly growing cancer which may metastasize to different organs of the body. [[Genes]] involved in the pathogenesis of squamous cell carcinoma include several oncogenes, such as: [[EGFR]], EML-4, KRAS, HER2, and ALK.<ref name="pmid22722794">{{cite journal |vauthors=Heist RS, Sequist LV, Engelman JA |title=Genetic changes in squamous cell lung cancer: a review |journal=J Thorac Oncol |volume=7 |issue=5 |pages=924–33 |year=2012 |pmid=22722794 |pmc=3404741 |doi=10.1097/JTO.0b013e31824cc334 |url=}}</ref> On gross pathology, findings include: central necrosis, cavitation, and invasion of peribronchial soft tissue. On microscopic histopathological analysis squamous cell carcinoma of the lung demonstrate large polygonal malignant cells containing keratin and intercellular bridges. | Squamous cell carcinoma of the lung arises from the [[epithelial]] cells of the lung of the central [[bronchi]] to terminal [[alveoli]], which are normally involved in the protection of the airways. Squamous cell carcinoma of the lung has a central location, and usually appears as a hiliar or perihiliar mass. Squamous cell carcinoma of the lung is a rapidly growing cancer which may metastasize to different organs of the body. [[Genes]] involved in the pathogenesis of squamous cell carcinoma include several oncogenes, such as: [[EGFR]], EML-4, KRAS, HER2, and ALK.<ref name="pmid22722794">{{cite journal |vauthors=Heist RS, Sequist LV, Engelman JA |title=Genetic changes in squamous cell lung cancer: a review |journal=J Thorac Oncol |volume=7 |issue=5 |pages=924–33 |year=2012 |pmid=22722794 |pmc=3404741 |doi=10.1097/JTO.0b013e31824cc334 |url=}}</ref> On gross pathology, findings include: central necrosis, cavitation, and invasion of peribronchial soft tissue. On microscopic histopathological analysis squamous cell carcinoma of the lung demonstrate large polygonal malignant cells containing keratin and intercellular bridges.<ref name="pmid16107574">{{cite journal |vauthors=Miller YE |title=Pathogenesis of lung cancer: 100 year report |journal=Am. J. Respir. Cell Mol. Biol. |volume=33 |issue=3 |pages=216–23 |year=2005 |pmid=16107574 |pmc=2715312 |doi=10.1165/rcmb.2005-0158OE |url=}}</ref> | ||
==Pathogenesis== | ==Pathogenesis== | ||
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===Molecular Pathogenesis=== | ===Molecular Pathogenesis=== | ||
* Squamous cell carcinoma of the lung is a diploid or hyperdiploid aneuploid neoplasm with mean chromosome numbers in the triploid range | * Squamous cell carcinoma of the lung is a diploid or hyperdiploid aneuploid neoplasm with mean chromosome numbers in the triploid range<ref name="pmid24488911">{{cite journal |vauthors=Shi WY, Liu KD, Xu SG, Zhang JT, Yu LL, Xu KQ, Zhang TF |title=Gene expression analysis of lung cancer |journal=Eur Rev Med Pharmacol Sci |volume=18 |issue=2 |pages=217–28 |year=2014 |pmid=24488911 |doi= |url=}}</ref> | ||
* In squamous cell carcinoma of the lung, there is a multitude of alterations with amplifications of the telomeric 3q region | * In squamous cell carcinoma of the lung, there is a multitude of alterations with amplifications of the telomeric 3q region | ||
* Gain of 3q24-qter is present in the majority of squamous cell carcinomas of the lung | * Gain of 3q24-qter is present in the majority of squamous cell carcinomas of the lung | ||
* Disruption of normal p53 gene is frequent in squamous cell carcinoma of the lung | * Disruption of normal p53 gene is frequent in squamous cell carcinoma of the lung<ref name="pmid24488911">{{cite journal |vauthors=Shi WY, Liu KD, Xu SG, Zhang JT, Yu LL, Xu KQ, Zhang TF |title=Gene expression analysis of lung cancer |journal=Eur Rev Med Pharmacol Sci |volume=18 |issue=2 |pages=217–28 |year=2014 |pmid=24488911 |doi= |url=}}</ref> | ||
==Genetics== | ==Genetics== | ||
* Development of squamous cell carcinoma of the lung is the result of multiple [[genetic mutation]]s. | * Development of squamous cell carcinoma of the lung is the result of multiple [[genetic mutation]]s. | ||
* Genetic mutations play an important role in the treatment selection for squamous cell carcinoma of the lung | * Genetic mutations play an important role in the treatment selection for squamous cell carcinoma of the lung | ||
* [[Genes]] involved in the pathogenesis of squamous cell carcinoma, include: | * [[Genes]] involved in the pathogenesis of squamous cell carcinoma, include:<ref name="pmid24488911">{{cite journal |vauthors=Shi WY, Liu KD, Xu SG, Zhang JT, Yu LL, Xu KQ, Zhang TF |title=Gene expression analysis of lung cancer |journal=Eur Rev Med Pharmacol Sci |volume=18 |issue=2 |pages=217–28 |year=2014 |pmid=24488911 |doi= |url=}}</ref> | ||
:*[[EGFR]] oncogene | :*[[EGFR]] oncogene | ||
::*84% of squamous cell carcinomas of the lung are positive for EGFR | ::*84% of squamous cell carcinomas of the lung are positive for EGFR | ||
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==Associated Conditions== | ==Associated Conditions== | ||
*There are no other conditions associated with squamous cell carcinoma of the lung | *There are no other conditions associated with squamous cell carcinoma of the lung<ref name="pmid24488911">{{cite journal |vauthors=Shi WY, Liu KD, Xu SG, Zhang JT, Yu LL, Xu KQ, Zhang TF |title=Gene expression analysis of lung cancer |journal=Eur Rev Med Pharmacol Sci |volume=18 |issue=2 |pages=217–28 |year=2014 |pmid=24488911 |doi= |url=}}</ref> | ||
==Gross Pathology== | ==Gross Pathology== | ||
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:*Intracellular bridges (classic feature) | :*Intracellular bridges (classic feature) | ||
*On inmunohistochemistry, findings associated with squamous cell carcinoma of the lung, include: | *On inmunohistochemistry, findings associated with squamous cell carcinoma of the lung, include:<ref name="pmid16107574">{{cite journal |vauthors=Miller YE |title=Pathogenesis of lung cancer: 100 year report |journal=Am. J. Respir. Cell Mol. Biol. |volume=33 |issue=3 |pages=216–23 |year=2005 |pmid=16107574 |pmc=2715312 |doi=10.1165/rcmb.2005-0158OE |url=}}</ref> | ||
:*Presence of p63 and high-molecular weight keratins for squamous cell carcinoma | :*Presence of p63 and high-molecular weight keratins for squamous cell carcinoma | ||
:*Other squamous immunomarkers include CK5/6, CEA, 34BE12, TTF-1, and CK7 | :*Other squamous immunomarkers include CK5/6, CEA, 34BE12, TTF-1, and CK7 | ||
Revision as of 16:39, 4 March 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Squamous cell carcinoma of the lung arises from the epithelial cells of the lung of the central bronchi to terminal alveoli, which are normally involved in the protection of the airways. Squamous cell carcinoma of the lung has a central location, and usually appears as a hiliar or perihiliar mass. Squamous cell carcinoma of the lung is a rapidly growing cancer which may metastasize to different organs of the body. Genes involved in the pathogenesis of squamous cell carcinoma include several oncogenes, such as: EGFR, EML-4, KRAS, HER2, and ALK.[1] On gross pathology, findings include: central necrosis, cavitation, and invasion of peribronchial soft tissue. On microscopic histopathological analysis squamous cell carcinoma of the lung demonstrate large polygonal malignant cells containing keratin and intercellular bridges.[2]
Pathogenesis
- Squamous cell carcinoma of the lung arises from the epithelial cells of the lung of the central bronchi to terminal alveoli, which are normally involved in the protection of the airways
- Squamous cell carcinoma of the lung arises from bronchial epithelial cell damage (related with active smoking)
- Squamous cell carcinoma of the lung has a central location, and usually appears as a hiliar or perihiliar mass
- Squamous cell carcinoma of the lung is a rapidly growing cancer which may metastasize to different organs of the body
- Basaloid lung cell carcinoma is the most aggressive subtype of squamous cell carcinoma of the lung
Molecular Pathogenesis
- Squamous cell carcinoma of the lung is a diploid or hyperdiploid aneuploid neoplasm with mean chromosome numbers in the triploid range[3]
- In squamous cell carcinoma of the lung, there is a multitude of alterations with amplifications of the telomeric 3q region
- Gain of 3q24-qter is present in the majority of squamous cell carcinomas of the lung
- Disruption of normal p53 gene is frequent in squamous cell carcinoma of the lung[3]
Genetics
- Development of squamous cell carcinoma of the lung is the result of multiple genetic mutations.
- Genetic mutations play an important role in the treatment selection for squamous cell carcinoma of the lung
- Genes involved in the pathogenesis of squamous cell carcinoma, include:[3]
- EGFR oncogene
- 84% of squamous cell carcinomas of the lung are positive for EGFR
- EML-4 oncogene
- ALK oncogene
- KRAS oncogene
- 30% of squamous cell carcinomas of the lung are positive for KRAS
- HER2 oncogene
- Rare in squamous cell carcinomas of the lung
Associated Conditions
- There are no other conditions associated with squamous cell carcinoma of the lung[3]
Gross Pathology
- On gross pathology, findings associated with squamous cell carcinoma of the lung, include:[4]
- Lung mass
- Usually centrally located
- Invasion of peribronchial soft-tissue, lymph nodes, and lung parenchyma
- Associated with a large airway
- May compress pulmonary artery and vein
- Usually have a central cavitation
Microscopic Pathology
- On microscopic pathology, findings associated with squamous cell carcinoma of the lung, include: [4]
- Central nucleus
- Dense appearing cytoplasm, usually eosinophilic
- Small nucleolus
- Intracellular bridges (classic feature)
- On inmunohistochemistry, findings associated with squamous cell carcinoma of the lung, include:[2]
- Presence of p63 and high-molecular weight keratins for squamous cell carcinoma
- Other squamous immunomarkers include CK5/6, CEA, 34BE12, TTF-1, and CK7
- Differentiation of squamous cell carcinoma of the lung from adenocarcinoma is vital as response to cytotoxic and biological agents will differ
Gallery
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Gross pathology: bronchial squamous lung cell cancer
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Gross pathology: Squamous lung cell cancer
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Gross pathology: cavitation, squamous lung cell cancer
References
- ↑ Heist RS, Sequist LV, Engelman JA (2012). "Genetic changes in squamous cell lung cancer: a review". J Thorac Oncol. 7 (5): 924–33. doi:10.1097/JTO.0b013e31824cc334. PMC 3404741. PMID 22722794.
- ↑ 2.0 2.1 Miller YE (2005). "Pathogenesis of lung cancer: 100 year report". Am. J. Respir. Cell Mol. Biol. 33 (3): 216–23. doi:10.1165/rcmb.2005-0158OE. PMC 2715312. PMID 16107574.
- ↑ 3.0 3.1 3.2 3.3 Shi WY, Liu KD, Xu SG, Zhang JT, Yu LL, Xu KQ, Zhang TF (2014). "Gene expression analysis of lung cancer". Eur Rev Med Pharmacol Sci. 18 (2): 217–28. PMID 24488911.
- ↑ 4.0 4.1 Non small cell lung cancer. Libre Pathology. http://librepathology.org/wiki/Non-small_cell_lung_carcinoma Accessed on February 22, 2016