Large-cell lung cancer is one of the histological types of non-small cell carcinomas of the lung.
It is thought to account for approximately 10% of bronchogenic carcinoma 1.
Patients present with dyspnea, chronic cough and haemoptysis.
Microscopically large cell carcinoma is characterised by large nuclei/nucleoli with a moderate amount of cytoplasm, hence the name large cell carcinoma. This undifferentiated tumour lacks distinctive features of small cell carcinoma, glandular or squamous differentiation. A histological subtype is of a large cell neuroendocrine carcinoma 3.
On immunophenotyping, characteristic features include 2:
- loss of staining with CK5/6
- CK14 positive in most squamous cell carcinoma (SCC)
- lack of MOC 31 positive in most adenocarcinomas
- positive immunoreactivity to EGFR, PDGFR-alpha and c-kit.
Large-cell lung cancer of the lung typically presents as a large peripheral mass of solid attenuation and irregular margin. Focal necrosis can be present. Other characteristics include rapid growth and early metastasis.
Treatment and prognosis
The histologic subtype of large cell neuroendocrine tumour has a more aggressive pattern and is associated with poorer prognosis.
- 1. Downey RS, Sewell CW, Mansour KA. Large cell carcinoma of the lung: a highly aggressive tumor with dismal prognosis. Ann. Thorac. Surg. 1989;47 (6): 806-8. Pubmed citation
- 2. Pardo J, Martinez-PeñUela AM, Sola JJ et-al. Large cell carcinoma of the lung: an endangered species?. Appl. Immunohistochem. Mol. Morphol. 2009;17 (5): 383-92. doi:10.1097/PAI.0b013e31819bfd59 - Pubmed citation
- 3. Oshiro Y, Kusumoto M, Matsuno Y et-al. CT findings of surgically resected large cell neuroendocrine carcinoma of the lung in 38 patients. AJR Am J Roentgenol. 2004;182 (1): 87-91. doi:10.2214/ajr.182.1.1820087 - Pubmed citation
Related Radiopaedia articles
lung cancer: an overview
non-small-cell lung cancer
- pre-invasive tumours
- minimally invasive tumours
- invasive tumours
- adenosquamous carcinoma
- large cell carcinoma
- primary sarcomatoid carcinoma of the lung
- squamous cell carcinoma
- salivary gland-type tumours
- pulmonary neuroendocrine tumours
- preinvasive lesions
- benign neoplasms
- pulmonary metastases
- lung cancer screening
- lung cancer staging
- non-small-cell lung cancer