Small cell carcinoma of the lung other diagnostic studies
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Small Cell Carcinoma of the Lung Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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.[1]
Biopsy
The confirmation of the diagnosis of SCLC relies on the histopathological findings of the tumor biopsy.[1]
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.[2]
References
- ↑ 1.0 1.1 NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014
- ↑ 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.