The incidence peaks around the 6th decade 6. There is an increased male predilection 7. They are rare and may accounts for ∼3% of all lung cancers, although the proportion of lung cancers diagnosed as large cell neuroendocrine carcinoma may be increasing 12.
Large cell neuroendocrine carcinoma of the lung is poorly differentiated and high-grade neuroendocrine tumors 10.
They have neuroendocrine morphology, neuroendocrine differentiation on immunohistochemistry, often high mitotic rates (>10 mitoses/mm2) and non-small cell cytological features 12.
As with other neuroendocrine cells of the lung, large cell neuroendocrine carcinoma arises from Kulchitsky cells of the bronchial mucosa 3.
There is a strong association with smoking 11.
CT features are non-specific. Large cell neuroendocrine carcinomas, in general, tend to present as oval-to-round and well-demarcated masses with lobulated margins. Their size typically ranges from 2 to 5 cm. Internal calcification is uncommon (9-21%) 2,4,7. A slight peripheral predilection may be present 5. There can be homogeneous or inhomogeneous enhancement following contrast 1.
Treatment and prognosis
- 1. 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
- 2. Shin AR, Shin BK, Choi JA et-al. Large cell neuroendocrine carcinoma of the lung: radiologic and pathologic findings. J Comput Assist Tomogr. 2000;24 (4): 567-73. Pubmed citation
- 3. Chong S, Lee KS, Chung MJ et-al. Neuroendocrine tumors of the lung: clinical, pathologic, and imaging findings. Radiographics. 2006;26 (1): 41-57. Radiographics (full text) - doi:10.1148/rg.261055057 - Pubmed citation
- 4. Takamochi K, Yokose T, Yoshida J et-al. Calcification in large cell neuroendocrine carcinoma of the lung. Jpn. J. Clin. Oncol. 2003;33 (1): 10-3. Pubmed citation
- 5. Jung KJ, Lee KS, Han J et-al. Large cell neuroendocrine carcinoma of the lung: clinical, CT, and pathologic findings in 11 patients. J Thorac Imaging. 2001;16 (3): 156-62. Pubmed citation
- 6. Hage R, Seldenrijk K, De Bruin P et-al. Pulmonary large-cell neuroendocrine carcinoma (LCNEC). Eur J Cardiothorac Surg. 2003;23 (4): 457-60. Pubmed citation
- 7. Akata S, Okada S, Maeda J et-al. Computed tomographic findings of large cell neuroendocrine carcinoma of the lung. Clin Imaging. 2007;31 (6): 379-84. doi:10.1016/j.clinimag.2007.04.027 - Pubmed citation
- 8. Iyoda A, Hiroshima K, Nakatani Y et-al. Pulmonary large cell neuroendocrine carcinoma: its place in the spectrum of pulmonary carcinoma. Ann. Thorac. Surg. 2007;84 (2): 702-7. doi:10.1016/j.athoracsur.2007.03.093 - Pubmed citation
- 9. Fernandez FG, Battafarano RJ. Large-cell neuroendocrine carcinoma of the lung. Cancer Control. 2007;13 (4): 270-5. Pubmed citation
- 10. Jiang SX, Kameya T, Shoji M et-al. Large cell neuroendocrine carcinoma of the lung: a histologic and immunohistochemical study of 22 cases. Am. J. Surg. Pathol. 1998;22 (5): 526-37. Pubmed citation
- 11. Fasano M, Della Corte CM, Papaccio F, Ciardiello F, Morgillo F. Pulmonary Large-Cell Neuroendocrine Carcinoma: From Epidemiology to Therapy. (2015) Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 10 (8): 1133-41. doi:10.1097/JTO.0000000000000589 - Pubmed
- 12. Derks JL, van Suylen RJ, Thunnissen E, den Bakker MA, Groen HJ, Smit EF, Damhuis RA, van den Broek EC, Speel EM, Dingemans AC. Chemotherapy for pulmonary large cell neuroendocrine carcinomas: does the regimen matter?. (2017) The European respiratory journal. doi:10.1183/13993003.01838-2016 - Pubmed