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{{Lung cancer}}
{{Lung cancer}}


{{CMG}}; '''Associate Editor(s)-In-Chief:''' Kim-Son H. Nguyen, M.D., M.P.A., Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA; {{CZ}}; {{Rim}}
{{CMG}}; {{AE}} {{KSH}} {{CZ}} {{Rim}} {{SH}}


==Overview==
==Overview==
Primary lung cancer can be classified into two main categories: [[small cell lung cancer]] (~15%) and [[non small cell lung cancer]] (~85%).  Non small cell lung cancer includes several subtypes grouped together because their prognosis and management are similar. The 2004 WHO histological classification of tumors of the lung categorized lung tumors into malignant epithelial tumors, benign epithelial tumors, lymphoproliferative tumors, miscellaneous tumors, and metastatic tumors.<ref name="WHO">{{cite book | last = Travis | first = William | title = Pathology and genetics of tumours of the lung, pleura, thymus, and heart | publisher = IARC Press | location = Lyon | year = 2004 | isbn = 9283224183 }}</ref>
Primary lung cancers may be [[Classification|classified]] into [[small cell lung cancer]] (~15%) and [[non small cell lung cancer]] (~85%).  [[Non small cell lung cancer]] are a [[heterogeneous]] group of lung cancers that are often grouped together because they share similar clinical features (e.g. [[prognosis]] and management). The 2015 [[World Health Organization|WHO]] [[Histology|histological]] [[classification]] of [[tumors]] of the [[lung]] categorized [[lung]] [[tumors]] into [[malignant]] [[epithelial]] [[tumors]], [[benign]] [[epithelial]] [[tumors]], [[Lymphoproliferative disorders|lymphoproliferative tumors]], miscellaneous [[tumors]], and [[metastatic]] [[tumors]].


==Classification==
==Classification==
Primary lung cancers may be [[Classification|classified]] into two main categories:<ref name="WHO">{{cite book | last = Travis | first = William | title = Pathology and genetics of tumours of the lung, pleura, thymus, and heart | publisher = IARC Press | location = Lyon | year = 2004 | isbn = 9283224183 }}</ref>
*[[Small cell lung cancer]] (~15%) 
*[[Non small cell lung cancer]] (~85%).
{{Family tree/start}}
{{Family tree/start}}
{{familytree | | | A01 | | | A01= '''Lung cancer'''}}
{{familytree | | | A01 | | | A01= '''Lung Cancer'''}}
{{familytree | |,|-|^|-|.| | }}
{{familytree | |,|-|^|-|.| | }}
{{familytree | B01 | | B02 | B01= <div style="float: left; text-align: left; width: 30em; padding:1em;">'''[[Small cell lung cancer]] (~15%) '''</div>| B02= <div style="float: left; text-align: left; width: 30em; padding:1em;">'''[[Non small cell lung cancer]] (~85%)'''<br>
{{familytree | B01 | | |!| | B01= <div style="float: left; text-align: left; width: 30em; padding:1em;">'''[[Small cell lung cancer]] (~15%) '''</div>}}
[[Squamous cell carcinoma of the lung|Squamous cell carcinoma]] (25% of lung cancers) <br>
 
[[Adenocarcinoma of the lung|Adenocarcinoma]] (40% of lung cancers) <br>
{{familytree | | | | | B02 | B02= <div style="float: left; text-align: left; width: 30em; padding:1em;">'''[[Non small cell lung cancer]] (~85%)'''<br>
[[Large cell carcinoma of the lung|Large cell carcinoma]] (10% of lung cancers) <br>
*[[Squamous cell carcinoma of the lung|Squamous cell carcinoma]] (25% of lung cancers) <br>
[[Adenosquamous carcinoma of the lung|Adenosquamous carcinoma]] <br>
*[[Adenocarcinoma of the lung|Adenocarcinoma]] (40% of lung cancers).
[[Carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements]] <br>
*[[Large cell carcinoma of the lung|Large cell carcinoma]] (10% of lung cancers)
[[Carcinoid tumor of the lung|Carcinoid tumor]] <br>
*Other non-small cell lung carcinomas:
[[Lung carcinoma of salivary gland type|Lung carcinoma of salivary gland type]]<br>
:*[[Adenosquamous carcinoma of the lung|Adenosquamous carcinoma]] <br>
[[Unclassified carcinoma of the lung|Unclassified carcinoma]] </div>}}
:*[[Carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements]] <br>
:*[[Carcinoid tumor of the lung|Carcinoid tumor]] <br>
:*[[Lung carcinoma of salivary gland type|Lung carcinoma of salivary gland type]]<br>
:*[[Unclassified carcinoma of the lung|Unclassified carcinoma]] </div>}}
{{Family tree/end}}
{{Family tree/end}}


* Primary lung cancer can be classified into two main categories: '''[[small cell lung cancer]]''' (~15%) and '''[[non small cell lung cancer]]''' (~85%).
==WHO Histological Classification of Tumors of the Lung ==
* There are three main sub-types of non small cell lung cancer , which are grouped together because their prognosis and management are similar:
The [[World Health Organization]] ([[World Health Organization|WHO]]) [[Classification|classifies]] [[tumors]] of the [[lungs]] as follows:<ref name="WHO">{{cite book | last = Travis | first = William | title = Pathology and genetics of tumours of the lung, pleura, thymus, and heart | publisher = IARC Press | location = Lyon | year = 2004 | isbn = 9283224183 }}</ref><ref name="urlwww.jto.org">{{cite web |url=https://www.jto.org/article/S1556-0864(15)33571-1/pdf |title=www.jto.org |format= |work= |accessdate=}}</ref>
** [[Squamous cell carcinoma of the lung|Squamous cell carcinoma]] (25% of lung cancers)
** [[Adenocarcinoma of the lung|Adenocarcinoma]] (40% of lung cancers) and large cell lung carcinoma (10% of lung cancers)
** [[Large cell carcinoma of the lung|Large cell carcinoma]] (10% of lung cancers)
* A subtype of adenocarcinoma, the [[bronchioloalveolar carcinoma]], is more common in female never-smokers, and may have different responses to treatment.<ref name="Raz">{{cite journal | last =Raz | first =DJ | coauthors =He B, Rosell R, Jablons DM | title =Bronchioloalveolar carcinoma: a review | journal =Clinical Lung Cancer | volume =7 | issue =5 | pages =313–322 | publisher =Cancer Information Group | date =Mar 2006 | pmid =16640802 }}</ref>
 
==WHO Histological Classification of Tumors of the Lung <ref name="WHO">{{cite book | last = Travis | first = William | title = Pathology and genetics of tumours of the lung, pleura, thymus, and heart | publisher = IARC Press | location = Lyon | year = 2004 | isbn = 9283224183 }}</ref>==
 
===Malignant Epithelial Tumors===
 
* [[Squamous cell carcinoma of the lung|Squamous cell carcinoma]]
:* Papillary
:* Clear cell
:* Small cell
:* Basaloid
 
* [[Small cell carcinoma of the lung|Small cell carcinoma]]
:* Combined small cell carcinoma
 
* [[Adenocarcinoma of the lung|Adenocarcinoma]]
:* Adenocarcinoma, mixed subtype
:* Acinar adenocarcinoma
:* Papillary adenocarcinoma
:* Bronchioloalveolar carcinoma
::* Nonmucinous
::* Mucinous
::* Mixed nonmucinous and mucinous or indeterminate
:* Solid adenocarcinoma with mucin production
::* Fetal adenocarcinoma
::* Mucinous (“colloid”) carcinoma
::* Mucinous cystadenocarcinoma
::* Signet ring adenocarcinoma
::* Clear cell adenocarcinoma
 
* [[Large cell carcinoma of the lung|Large cell carcinoma]]
:* Large cell neuroendocrine carcinoma
::* Combined large cell neuroendocrine carcinoma
:* Basaloid carcinoma
:* Lymphoepithelioma-like carcinoma
:* Clear cell carcinoma
:* Large cell carcinoma with rhabdoid phenotype
 
* [[Large cell carcinoma of the lung|Adenosquamous carcinoma]]
 
* [[Sarcomatoid carcinoma of the lung|Sarcomatoid carcinoma]]
:* Pleomorphic carcinoma
:* Spindle cell carcinoma
:* Giant cell carcinoma
:* Carcinosarcoma
:* Pulmonary blastoma


* [[Carcinoid tumor of the lung|Carcinoid tumor]]
{| class="wikitable"
:* Typical carcinoid
|+
:* Atypical carcinoid
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" ! | WHO Classification of Lung Tumors
 
|-
* [[Salivary gland tumors of the lung|Salivary gland tumors]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histological type
:* Mucoepidermoid carcinoma
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Subtype
:* Adenoid cystic carcinoma
|-
:* Epithelial-myoepithelial carcinoma
! colspan="2" style="background: #707070; color: #FFFFFF; text-align: center;" |Epithelial tumors
 
|-
* Preinvasive lesions
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Adenocarcinoma of the lung|'''Adenocarcinoma''']]
:* Squamous carcinoma in situ
|
:* Atypical adenomatous hyperplasia
*[[Lepidic adenocarcinoma of the lung|Lepidic adenocarcinoma]]
:* Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia
*[[Acinar adenocarcinoma of the lung|Acinar adenocarcinoma]]
 
*[[Papillary adenocarcinoma of the lung|Papillary adenocarcinoma]]
* Mesenchymal tumors
*[[Micropapillary adenocarcinoma of the lung|Micropapillary adenocarcinoma]]
:* Epithelioid haemangioendothelioma
*[[Solid adenocarcinoma of the lung|Solid adenocarcinoma]]
:* Angiosarcoma
*[[Invasive mucinous adenocarcinoma of the lung|Invasive mucinous adenocarcinoma]]
:* Pleuropulmonary blastoma
** Mixed invasive mucinous
:* Chondroma
** Nonmucinous adenocarcinoma
:* Congenial peribronchial myofibroblastic tumor
*[[Colloid adenocarcinoma of the lung|Colloid adenocarcinoma]]
:* Diffuse pulmonary lymphangiomatosis
*[[Fetal adenocarcinoma of the lung|Fetal adenocarcinoma]]
:* Inflammatory myofibroblastic tumor
*[[Enteric adenocarcinoma of the lung|Enteric adenocarcinoma]]
:* Lymphangioleiomyomatosis
*[[Minimally invasive adenocarcinoma of the lung|Minimally invasive adenocarcinoma]]
:* Synovial sarcoma
** Nonmucinous
::* Monophasic
** Mucinous
::* Biphasic
* Pre-[[Invasive (medical)|invasive]] [[Lesion|lesions]]
:* Pulmonary artery sarcoma
**[[Atypical adenomatous hyperplasia of the lung|Atypical adenomatous hyperplasia]]
:* Pulmonary vein sarcoma
**[[Adenocarcinoma of the lung|Adenocarcinoma]] in situ
 
*** Nonmucinous
===Benign Epithelial Tumors===
*** Mucinous
 
|-
* Papillomas
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Squamous cell carcinoma of the lung|Squamous cell carcinoma]]'''
:* Squamous cell papilloma
|
::* Exophytic
* Keratinizing squamous cell carcinoma
::* Inverted
* Nonkeratinizing squamous cell carcinoma
:* Glandular papilloma
* Basaloid squamous cell carcinoma
:* Mixed squamous cell and glandular papilloma
* Pre-[[Invasive (medical)|invasive]] [[lesion]]
 
** Squamous cell carcinoma in situ
* Adenomas
|-
:* Alveolar adenoma
! colspan="2" style="background: #707070; color: #FFFFFF; text-align: center;" |'''Neuroendocrine tumors'''
:* Papillary adenoma
|-
:* Adenomas of the salivary gland type
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Small cell carcinoma of the lung|Small cell carcinoma]]'''
::* Mucous gland adenoma
|
::* Pleomorphic adenoma
* Combined [[Small cell carcinoma of lung|small cell carcinoma]]
::* Others
|-
:* Mucinous cystadenoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Large cell neuroendocrine carcinoma of the lung|Large cell neuroendocrine carcinoma]]'''
 
|
===Lymphoproliferative Tumors===
* Combined [[Large cell neuroendocrine carcinoma of the lung|large cell neuroendocrine carcinoma]]
 
|-
* Marginal zone B-cell lymphoma of the MALT type
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Carcinoid syndrome|Carcinoid tumors]]'''
* Diffuse large B-cell lymphoma
|
* Lymphomatoid granulomatosis
*[[Carcinoid tumor|Typical carcinoid tumor]]
* Langerhans cell histiocytosis
*[[Carcinoid tumor|Atypical carcinoid tumor]]
 
|-
===Miscellaneous Tumors===
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Pre-[[Invasive (medical)|invasive]] [[lesion]]'''
 
|
* Hamartoma
*[[Diffuse]] [[idiopathic]] [[Lung|pulmonary]] [[neuroendocrine cell]] [[hyperplasia]]
* Sclerosing hemangioma
|-
* Clear cell tumor
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Large cell carcinoma of the lung|Large cell carcinoma]]'''
* Germ cell tumors
|
:* Teratoma, mature
* N/A
:* Immature
|-
:* Other germ cell tumors
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Adenosquamous carcinoma]]'''
 
|
* Intrapulmonary thymoma
* N/A
 
|-
* Melanoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Sarcomatoid carcinoma of the lung|Sarcomatoid carcinomas]]'''
 
|
===Metastatic Tumors===
*[[Pleomorphic carcinoma of the lung|Pleomorphic carcinoma]]
*[[Spindle cell carcinoma of the lung|Spindle cell carcinoma]]
*[[Giant cell carcinoma of the lung|Giant cell carcinoma]]
*[[Carcinosarcoma of the lung|Carcinosarcoma]]
*[[Pulmonary blastoma of the lung|Pulmonary blastoma]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Other and [[Classification|Unclassified]] [[Carcinoma|carcinomas]]'''
|
*[[Lymphoepithelioma-like carcinoma of the lung|Lymphoepithelioma-like carcinoma]]
* NUT carcinoma
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Salivary gland]]-type [[Tumor|tumors]]'''
|
*[[Mucoepidermoid carcinoma]]
* Adenoid cystic carcinoma
*[[Epithelium|Epithelial]]-[[myoepithelial]] [[carcinoma]]
*[[Pleomorphic adenoma]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Papilloma|Papillomas]]'''
|
*[[Squamous cell papilloma]]
** Exophytic
** Inverted
*[[Gland|Glandular]] [[papilloma]]
* Mixed [[squamous]] and [[Gland|glandular]] [[papilloma]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Adenoma|Adenomas]]'''
|
* Sclerosing pneumocytoma
*[[Alveolar]] [[adenoma]]
*[[Papilla|Papillary]] [[adenoma]]
*[[Mucinous cystadenoma]]
*[[Mucous gland]] [[adenoma]]
|-
! colspan="2" style="background: #707070; color: #FFFFFF; text-align: center;" |'''Mesenchymal tumors'''
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hamartoma|'''Pulmonary hamartoma''']]
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Chondroma]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[PEComa|PEComatous tumors]]'''
|
* [[Lymphangiomyomatosis|Lymphangioleiomyomatosis]]
* [[PEComa]] (benign)
**[[Clear cell tumor]]
*[[PEComa]] ([[malignant]])
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Congenital peribronchial myofibroblastic tumor'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Diffuse [[Lung|pulmonary]] [[lymphangiomatosis]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Inflammation|Inflammatory]] [[Myofibroblast|myofibroblastic]] [[tumor]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vascular tumor|'''Epithelioid hemangioendothelioma''']]
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pleuropulmonary blastoma|'''Pleuropulmonary blastoma''']]
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Synovial sarcoma]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Pulmonary artery]] [[Tunica intima|intimal]] [[sarcoma]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Pulmonary myxoid sarcoma with EWSR1–CREB1 [[translocation]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" | '''[[Myoepithelial]] [[Tumor|tumors]]'''
|
*[[Myoepithelial cells|Myoepithelioma]]
*[[Myoepithelial]] [[carcinoma]]
|-
! colspan="2" style="background: #707070; color: #FFFFFF; text-align: center;" |'''Lymphohistiocytic tumors'''
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Extranodal marginal zone lymphomas of [[MALT lymphoma|mucosa-associated Lymphoid tissue (MALT lymphoma)]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Diffuse large cell [[lymphoma]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lymphomatoid granulomatosis|'''Lymphomatoid granulomatosis''']]
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Intravascular large [[B cell]] [[lymphoma]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Lung|Pulmonary]] [[Langerhans cell histiocytosis]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Erdheim-Chester disease'''
|
* N/A
|-
! colspan="2" style="background: #707070; color: #FFFFFF; text-align: center;" |'''Tumors of ectopic origin'''
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Germ cell tumor|Germ cell tumors]]'''
|
* Mature [[teratoma]]
* Immature [[teratoma]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Pulmonary|Intrapulmonary]] [[thymoma]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Melanoma]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Meningioma]], [[NOS]]'''
|
* N/A
|}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Disease]]
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Latest revision as of 18:12, 2 July 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kim-Son H. Nguyen M.D. Cafer Zorkun, M.D., Ph.D. [2] Rim Halaby, M.D. [3] Dildar Hussain, MBBS [4]

Overview

Primary lung cancers may be classified into small cell lung cancer (~15%) and non small cell lung cancer (~85%). Non small cell lung cancer are a heterogeneous group of lung cancers that are often grouped together because they share similar clinical features (e.g. prognosis and management). The 2015 WHO histological classification of tumors of the lung categorized lung tumors into malignant epithelial tumors, benign epithelial tumors, lymphoproliferative tumors, miscellaneous tumors, and metastatic tumors.

Classification

Primary lung cancers may be classified into two main categories:[1]

 
 
Lung Cancer
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

WHO Histological Classification of Tumors of the Lung

The World Health Organization (WHO) classifies tumors of the lungs as follows:[1][2]

WHO Classification of Lung Tumors
Histological type Subtype
Epithelial tumors
Adenocarcinoma
Squamous cell carcinoma
  • Keratinizing squamous cell carcinoma
  • Nonkeratinizing squamous cell carcinoma
  • Basaloid squamous cell carcinoma
  • Pre-invasive lesion
    • Squamous cell carcinoma in situ
Neuroendocrine tumors
Small cell carcinoma
Large cell neuroendocrine carcinoma
Carcinoid tumors
Pre-invasive lesion
Large cell carcinoma
  • N/A
Adenosquamous carcinoma
  • N/A
Sarcomatoid carcinomas
Other and Unclassified carcinomas
Salivary gland-type tumors
Papillomas
Adenomas
Mesenchymal tumors
Pulmonary hamartoma
  • N/A
Chondroma
  • N/A
PEComatous tumors
Congenital peribronchial myofibroblastic tumor
  • N/A
Diffuse pulmonary lymphangiomatosis
  • N/A
Inflammatory myofibroblastic tumor
  • N/A
Epithelioid hemangioendothelioma
  • N/A
Pleuropulmonary blastoma
  • N/A
Synovial sarcoma
  • N/A
Pulmonary artery intimal sarcoma
  • N/A
Pulmonary myxoid sarcoma with EWSR1–CREB1 translocation
  • N/A
Myoepithelial tumors
Lymphohistiocytic tumors
Extranodal marginal zone lymphomas of mucosa-associated Lymphoid tissue (MALT lymphoma)
  • N/A
Diffuse large cell lymphoma
  • N/A
Lymphomatoid granulomatosis
  • N/A
Intravascular large B cell lymphoma
  • N/A
Pulmonary Langerhans cell histiocytosis
  • N/A
Erdheim-Chester disease
  • N/A
Tumors of ectopic origin
Germ cell tumors
Intrapulmonary thymoma
  • N/A
Melanoma
  • N/A
Meningioma, NOS
  • N/A

References

  1. 1.0 1.1 Travis, William (2004). Pathology and genetics of tumours of the lung, pleura, thymus, and heart. Lyon: IARC Press. ISBN 9283224183.
  2. "www.jto.org".

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