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| Small Cell Carcinoma |
| Etiology • Associated with cigarette smoking. |
| Pathogenesis • BPDE (catabolite of benzo[a]pyrene in cigarette smoke) binds p53 mutational hot spots in lung carcinoma • p53 mutation affects cell replication and centromere replication, |
| Epidemiology • Increasing incidence with age, smoking history. • More frequent in men than women. |
| General Gross Description • These neoplasms tend to be perihilar and surround large bronchi. • Ill defined, grey white or hemorrhagic. • May be far more extensive microscopically than expected on gross evaluation. |
| General Microscopic Description • Densely cellular "little blue cell" neoplasms. • Fragile cells are easily crushed resulting in blue streaks. • Almost no cytoplasm so nuclei appear molded to each other. • Nuclei are so hyperchromatic and irregular that nucleoli are rarely visualized. • Although there are fusiform, oat, and intermediate cell types, no difference in outcome. • Dense core neurosecretory granules. • May stain with chromagranin, neuron specific enolase, or synaptophysin. |
| Clinical Correlation • Highly aggressive neoplasms that frequently present with evidence of metastatic disease. • Most likely to be associated with ectopic hormone product • Central location associated with cough and hemoptysis • Weight loss and dyspnea • Staging depends on whether confined to one hemithorax • Metastatic disease to lymph nodes, brain, liver and adrenal glands • Treatment depends on chemotherapy. • Overall two year survival 25% |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 720-725. |
| Small Cell Carcinoma |
| Synopsis by: Melinda Sanders M.D. (T28000M80413)[232] |
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