Lung cancer classification: Difference between revisions

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==Overview==
==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 heterogenous group of lung cancers that are often grouped together because they share similar clinical features (e.g. [[prognosis]] and management). The 2004 WHO 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]].
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 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>  
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%)   
*[[Small cell lung cancer]] (~15%)   
*[[Non small cell lung cancer]] (~85%).
*[[Non small cell lung cancer]] (~85%).
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==WHO Histological Classification of Tumors of the Lung ==
==WHO Histological Classification of Tumors of the Lung ==
The [[World Health Organization]] ([[World Health Organization|WHO]]) classifies [[tumors]] of the [[lungs]] as follows:<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><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>
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>


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


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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