Small cell carcinoma of the lung other diagnostic studies: Difference between revisions

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{{CMG}}
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==Overview==
==Overview==
Among patients with small cell lung cancer (SCLC) who have [[pleural effusion]] large enough to be sampled, [[thoracentesis]] should be performed. The results of the analysis of the pleural effusion fluid should be considered in the staging of the patient. In addition, pathological mediastinal staging in selected patients should be performed through either [[mediastinoscopy]], mediastinotomy, video assisted [[thoracoscopy]], or endobronchial/esophageal guided ultrasound [[biopsy]].  Moreover, [[bone marrow biopsy]] is required among SCLC who have evidence on [[blood smear]] of nucleated [[red blood cells]], [[neutropenia]], or [[thrombocytopenia]].<ref name=NCCN>[http://www.nccn.org/professionals/physician_gls/f_guidelines_nojava.asp NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014] </ref>
Among patients with small cell lung cancer (SCLC) who have [[pleural effusion]] large enough to be sampled, [[thoracentesis]] should be performed. The results of the analysis of the [[pleural effusion]] should be considered in the staging of the lesion. In addition, [[pathological]] [[mediastinal]] staging in selected patients should be performed through either [[mediastinoscopy]], video assisted [[thoracoscopy]], or endobronchial/[[esophageal]] guided [[ultrasound]] [[biopsy]].  Moreover, [[bone marrow biopsy]] is required among SCLC who have evidence on [[blood smear]] of nucleated [[red blood cells]], [[neutropenia]], or [[thrombocytopenia]].
===Biopsy===
The confirmation of the diagnosis of SCLC relies on the histopathological findings of the tumor [[biopsy]].<ref name="NCCN">[http://www.nccn.org/professionals/physician_gls/f_guidelines_nojava.asp NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014] </ref>


In SCLC, the tumor cells are small and round, but they can sometimes be ovoid or spindle shaped.  They have a scant [[cytoplasm]] with a high mitotic count and a hyperchromatic [[nuclei]].  Nearly all SCLC are immunoreactive for [[keratin]], [[thyroid transcription factor 1]], and epithelial membrane antigen.  Neuroendocrine and neural differentiation result in the expression of molecules like dopa decarboxylase, [[calcitonin]], neuron-specific [[enolase]], [[chromogranin A]], [[CD56]] (also known as nucleosomal histone kinase 1 or neural-cell adhesion molecule), gastrin-releasing peptide, and [[insulin-like growth factor 1]].  One or more markers of neuroendocrine differentiation can be found in approximately 75% of SCLC.<ref name="NCI">National Cancer Institute: PDQ® Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute.  Available at: http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/healthprofessional.</ref>
== Other Diagnostic Studies ==


<div align="left">
* Among patients with small cell lung cancer (SCLC) who have [[pleural effusion]] large enough to be sampled, [[thoracentesis]] should be performed.<ref name="NCCN">[http://www.nccn.org/professionals/physician_gls/f_guidelines_nojava.asp NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014] </ref>
<gallery heights="175" widths="175">
* The results of the analysis of the [[pleural effusion]] should be considered in the [[Cancer staging|staging]] of the [[lesion]].<ref name="NCCN" />
Image:Lung small cell carcinoma (1) by core needle biopsy.jpg|Histopathologic image of small cell carcinoma of the lung. CT-guided core needle biopsy. H & E stain.
* [[Pathological]] [[mediastinal]] staging in selected patients should be performed through either [[mediastinoscopy]], video assisted [[thoracoscopy]], or endobronchial/[[esophageal]] guided [[ultrasound]] [[biopsy]].
Image:Lung small cell cancer 01.jpeg|Micrograph of a small-cell carcinoma of the lung showing cells with nuclear molding, minimal amount of cytoplasm and stippled chromatin. FNA specimen. Field stain.
* [[Bone marrow biopsy]] is required among SCLC who have evidence on [[blood smear]] of nucleated [[red blood cells]], [[neutropenia]], or [[thrombocytopenia]].
Image:Lung small cell cancer 03.jpeg|Anaplastic (microcellular, oat cell) carcinoma from the lung.
</gallery>
</div>


<div align="left">
<gallery heights="175" widths="175">
Image:Lung small cell cancer 04.jpeg|Histopathologic image of small-cell carcinoma of the lung. CT-guided core needle biopsy.
Image:Lung small cell cancer 05.jpeg|Small cell carcinoma, pleural FNA.
</gallery>
</div>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 23:32, 4 September 2019

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Overview

Among patients with small cell lung cancer (SCLC) who have pleural effusion large enough to be sampled, thoracentesis should be performed. The results of the analysis of the pleural effusion should be considered in the staging of the lesion. In addition, pathological mediastinal staging in selected patients should be performed through either mediastinoscopy, video assisted thoracoscopy, or endobronchial/esophageal guided ultrasound biopsy. Moreover, bone marrow biopsy is required among SCLC who have evidence on blood smear of nucleated red blood cells, neutropenia, or thrombocytopenia.

Other Diagnostic Studies

References


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