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Lung tumor

Other Carcinoma

Large cell undifferentiated carcinoma

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 3 November 2014, last major update September 2012
Copyright: (c) 2003-2014, PathologyOutlines.com, Inc.


● 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

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

Gross description

● 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

● 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

Rhabdoid cells

Various images

Tumors reclassified and unable to be reclassified with extended IHC panel

Virtual slides

Anaplastic tumor cells

Positive stains

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

Electron microscopy description

● 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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