Large cell neuroendocrine carcinoma of the lung
Citation, DOI, disclosures and article data
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Kieran Kusel had no financial relationships to ineligible companies to disclose.
View Kieran Kusel's current disclosures- Undifferentiated large-cell carcinoma of the lung
- Large cell neuroendocrine carcinomas
- Large cell neuroendocrine carcinoma of the lungs
- Large cell neuroendocrine carcinoma of lung
- Large cell neuroendocrine carcinoma (LCNEC)
- LCNEC lung
- Large cell neuroendocrine cell carcinoma of the lung
- Large cell neuroendocrine cell carcinoma of lung
- LCNECs 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.
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Epidemiology
The incidence peaks around the 6th decade 6. There is an increased male predilection 7. They are rare and account for ∼3% of all lung cancers, although the proportion of lung cancers diagnosed as large cell neuroendocrine carcinoma may be increasing 12.
Pathology
Large cell neuroendocrine carcinoma of the lung is a poorly differentiated high-grade neuroendocrine tumor 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 tumors of the lung, large cell neuroendocrine carcinoma arises from Kulchitsky cells of the bronchial mucosa 3.
Associations
There is a strong association with smoking 11.
Radiographic features
CT
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
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.
References
- 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
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