Large-cell carcinoma (LCC, LCLC) is a heterogeneous group of undifferentiated malignant neoplasms that lack the cytologic and architectural features of small cell carcinoma and glandular or squamous differentiation. LCC is categorized as a type of NSCLC (

non-small-cell lung carcinoma Non-small-cell lung cancer (NSCLC) is any type of epithelial lung cancer other than small-cell lung carcinoma (SCLC). NSCLC accounts for about 85% of all lung cancers. As a class, NSCLCs are relatively insensitive to chemotherapy, compared to s ...

) which originates from epithelial cells of the lung.

Presentation

Patients typically present with a non-productive cough and weight loss.

Diagnosis

LCC is, in effect, a "diagnosis of exclusion", in that the tumor cells lack light microscopic characteristics that would classify the neoplasm as a small-cell carcinoma, squamous-cell carcinoma, adenocarcinoma, or other more specific histologic type of lung cancer. LCC is differentiated from

small-cell lung carcinoma Small-cell carcinoma is a type of highly malignant cancer that most commonly arises within the lung, although it can occasionally arise in other body sites, such as the cervix, prostate, and gastrointestinal tract. Compared to non-small cell car ...

(SCLC) primarily by the larger size of the

anaplastic Anaplasia (from grc, ἀνά ''ana'', "backward" + πλάσις ''plasis'', "formation") is a condition of cells with poor cellular differentiation, losing the morphological characteristics of mature cells and their orientation with respect to e ...

cells, a higher cytoplasmic-to-nuclear size ratio, and a lack of "salt-and-pepper" chromatin.

Classification

The newest revisions of the

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level o ...

(WHO) "Histological Typing of Lung Cancer schema" include several variants of LCC, including: *

Giant-cell carcinoma of the lung Giant-cell carcinoma of the lung (GCCL) is a rare histological form of large-cell lung carcinoma, a subtype of undifferentiated lung cancer, traditionally classified within the non-small-cell lung carcinomas (NSCLC). The characteristic feature ...

Basaloid large cell carcinoma of the lung Basaloid large cell carcinoma of the lung, is a rare histological variant of lung cancer featuring certain distinctive cytological, tissue architectural, and immunohistochemical characteristics and clinical behavior. Classification Lung cancer ...

* Clear cell carcinoma of the lung * Lymphoepithelioma-like carcinoma of the lung *

Large-cell lung carcinoma with rhabdoid phenotype Large cell lung carcinoma with rhabdoid phenotype (LCLC-RP) is a rare histological form of lung cancer, currently classified as a variant of large cell lung carcinoma (LCLC). In order for a LCLC to be subclassified as the rhabdoid phenotype varia ...

Large cell neuroendocrine carcinoma of the lung Large cell neuroendocrine carcinoma of the lung (LCNEC) is a highly malignant neoplasm arising from transformed epithelial cells originating in tissues within the pulmonary tree. It is currently considered to be a subtype of large cell lung carcin ...

Large-cell neuroendocrine carcinoma (LCNEC)

One clinically significant subtype is "large-cell neuroendocrine carcinoma" (LCNEC), which is believed to derive from

neuroendocrine Neuroendocrine cells are cells that receive neuronal input (through neurotransmitters released by nerve cells or neurosecretory cells) and, as a consequence of this input, release messenger molecules (hormones) into the blood. In this way they bri ...

cells. In addition, a "subvariant", called "combined large-cell neuroendocrine carcinoma" (or c-LCNEC), is recognized under the new system. To be designated a c-LCNEC, the tumor must contain at least 10% LCNEC cells, in combination with at least 10% of other forms of NSCLC.

Pathology images

File:Large cell carcinoma of the lung.jpg File:Large cell carcinoma of the lung .jpg

Incidence

In most series, LCLC's comprise between 5% and 10% of all

lung cancer Lung cancer, also known as lung carcinoma (since about 98–99% of all lung cancers are carcinomas), is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung. Lung carcinomas derive from transformed, mali ...

s. According to the

Nurses' Health Study The Nurses Health Study is a series of prospective studies that examine epidemiology and the long-term effects of nutrition, hormones, environment, and nurses' work-life on health and disease development. The studies have been among the largest in ...

, the risk of large cell lung carcinoma increases with a previous history of

tobacco smoking Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is generally done with pipes and cigars. The practice is beli ...

, with a previous smoking duration of 30 to 40 years giving a

relative risk The relative risk (RR) or risk ratio is the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group. Together with risk difference and odds ratio, relative risk measures the association be ...

of approximately 2.3 compared to never-smokers, and a duration of more than 40 years giving a relative risk of approximately 3.6. Another study concluded that cigarette smoking is the predominant cause of large cell lung cancer. It estimated that the odds ratio associated with smoking two or more packs/day for current smokers is 37.0 in men and 72.9 in women. Notabled people with the condition include, American comedian

Andy Kaufman Andrew Geoffrey Kaufman ( ; January 17, 1949 – May 16, 1984) was an American entertainer and performance artist. While often called a "comedian", Kaufman preferred to describe himself instead as a "song and dance man". He has sometimes b ...

, who died from the disease in 1984.

References

External links

World Health Organization Histological Classification of Lung and Pleural Tumours. 4th Edition. {{Respiratory and intrathoracic neoplasia Lung cancer