Large cell neuroendocrine carcinoma of the lung

Large cell neuroendocrine carcinoma (LCNEC) of the lung is classified as a subtype of large cell carcinoma of the lung. It is also classified as a pulmonary neuroendocrine tumor.

Epidemiology

The incidence peaks around the sixth decade ⁶. There is an increased male predilection ⁷.

Pathology

LCNECs are poorly differentiated and high-grade neuroendocrine tumors ¹⁰. As with other neuroendocrine cells of the lung, LCNECs arise from Kulchitzky cells of the bronchial mucosa ³.

Associations

There is a strong association with smoking ¹¹.

Radiographic features

CT

CT features are non-specific. LCNECs, 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

They tend to be aggressive high-grade tumors with a poor prognosis ⁶. The overall prognosis is thought to be between that of an atypical pulmonary carcinoid and small cell lung cancer ³.