Large cell neuroendocrine carcinoma of the lung

Last revised by Craig Hacking on 04 Jun 2020

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.

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.

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.

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Cases and figures

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