Lung tumor - Large cell undifferentiated carcinoma

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Lung tumor

Other Carcinoma

Large cell undifferentiated carcinoma

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 12 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Malignant epithelial neoplasm composed of large, atypical cells; subtypes include Basaloid carcinoma, Large cell neuroendocrine carcinoma, Large cell carcinoma with rhabdoid phenotype, Lymphoepithelial carcinoma (WHO)
● Tumor with solid nests of large polygonal and anaplastic cells without obvious squamous or glandular differentiation; may be undifferentiated squamous cell carcinoma or adenocarcinoma
● Diagnosis of exclusion - cannot diagnose on small biopsies or in lymph node metastases
● Extended panel of immunohistochemical markers can reclassify 60%; miRNA-based analysis can reclassify the balance, but clinical relevance is unknown (Am J Clin Pathol 2011;136:773)
● 80% men
● Often associated with peripheral eosinophilia and leukocytosis, due to tumor production of colony stimulating factor
● Behavior is similar to adenocarcinoma

Case reports
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● 58 year old man presenting with paroxysmal abdominal pain (World J Surg Oncol 2012 Jan 29;10:26)

Gross description
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● Usually peripheral lung; spherical tumor with well-defined borders and bulging, fleshy, homogenous gray-white cut surface
● No anthracosis
● Frequently involves thoracic wall

Micro description
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● Large polygonal cells and anaplastic cells growing in solid nests without obvious squamous or glandular differentiation
● Moderately abundant cytoplasm, well defined cell borders, vesicular nuclei, prominent nucleoli

Micro images
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Rhabdoid cells

Various images

Tumors reclassified and unable to be reclassified with extended IHC panel

Virtual slides
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Anaplastic tumor cells

Positive stains
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● CK5 (56%), calretinin (38%), thrombomodulin (25%), mesothelin (13%), TTF1 (variable)

Electron microscopy description
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● Glandular (intracellular and extracellular lumina) and squamous (desmosomes, tonofilaments) features often present although not obvious with H & E staining

End of Lung tumor > Other carcinoma > Large cell undifferentiated carcinoma

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