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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 cancers may be classified into two main categories: [[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 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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*[[Squamous cell carcinoma of the lung|Squamous cell carcinoma]] (25% of lung cancers) <br>
*[[Squamous cell carcinoma of the lung|Squamous cell carcinoma]] (25% of lung cancers) <br>
*[[Adenocarcinoma of the lung|Adenocarcinoma]] (40% of lung cancers).  
*[[Adenocarcinoma of the lung|Adenocarcinoma]] (40% of lung cancers).  
:*[[Bronchioloalveolar carcinoma]] is a subtype of adenocarcinoma, is more common among female never-smokers, and may have different responses to treatment.<br><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>
*[[Large cell carcinoma of the lung|Large cell carcinoma]] (10% of lung cancers)
*[[Large cell carcinoma of the lung|Large cell carcinoma]] (10% of lung cancers)
*Other non-small cell lung carcinomas:
*Other non-small cell lung carcinomas:
Line 31: Line 30:


==WHO Histological Classification of Tumors of the Lung ==
==WHO Histological Classification of Tumors of the Lung ==
The World Health Organization (WHO) 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>
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>
===Malignant Epithelial Tumors===
====Squamous cell carcinoma====
* Papillary
* Clear cell
* Small cell
* Basaloid


====Small cell carcinoma====
{| class="wikitable"
* Combined small cell carcinoma
|+
 
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" ! | WHO Classification of Lung Tumors
====Adenocarcinoma====
|-
* Adenocarcinoma, mixed subtype
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histological type
* Acinar adenocarcinoma
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Subtype
* Papillary adenocarcinoma
|-
* Bronchioloalveolar carcinoma
! colspan="2" style="background: #707070; color: #FFFFFF; text-align: center;" |Epithelial tumors
:* Nonmucinous
|-
:* Mucinous
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Adenocarcinoma of the lung|'''Adenocarcinoma''']]
:* Mixed nonmucinous and mucinous or indeterminate
|
* Solid adenocarcinoma with mucin production
*[[Lepidic adenocarcinoma of the lung|Lepidic adenocarcinoma]]
:* Fetal adenocarcinoma
*[[Acinar adenocarcinoma of the lung|Acinar adenocarcinoma]]
:* Mucinous (“colloid”) carcinoma
*[[Papillary adenocarcinoma of the lung|Papillary adenocarcinoma]]
:* Mucinous cystadenocarcinoma
*[[Micropapillary adenocarcinoma of the lung|Micropapillary adenocarcinoma]]
:* Signet ring adenocarcinoma
*[[Solid adenocarcinoma of the lung|Solid adenocarcinoma]]
:* Clear cell adenocarcinoma
*[[Invasive mucinous adenocarcinoma of the lung|Invasive mucinous adenocarcinoma]]
 
** Mixed invasive mucinous
====Large cell carcinoma====
** Nonmucinous adenocarcinoma
* Large cell neuroendocrine carcinoma
*[[Colloid adenocarcinoma of the lung|Colloid adenocarcinoma]]
:* Combined large cell neuroendocrine carcinoma
*[[Fetal adenocarcinoma of the lung|Fetal adenocarcinoma]]
* Basaloid carcinoma
*[[Enteric adenocarcinoma of the lung|Enteric adenocarcinoma]]
* Lymphoepithelioma-like carcinoma
*[[Minimally invasive adenocarcinoma of the lung|Minimally invasive adenocarcinoma]]
* Clear cell carcinoma
** Nonmucinous
* Large cell carcinoma with rhabdoid phenotype
** Mucinous
 
* Pre-[[Invasive (medical)|invasive]] [[Lesion|lesions]]
====Adenosquamous carcinoma====
**[[Atypical adenomatous hyperplasia of the lung|Atypical adenomatous hyperplasia]]
 
**[[Adenocarcinoma of the lung|Adenocarcinoma]] in situ
====Sarcomatoid carcinoma====
*** Nonmucinous
* Pleomorphic carcinoma
*** Mucinous
* Spindle cell carcinoma
|-
* Giant cell carcinoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Squamous cell carcinoma of the lung|Squamous cell carcinoma]]'''
* Carcinosarcoma
|
* Pulmonary blastoma
* Keratinizing squamous cell carcinoma
 
* Nonkeratinizing squamous cell carcinoma
====Carcinoid tumor====
* Basaloid squamous cell carcinoma
* Typical carcinoid
* Pre-[[Invasive (medical)|invasive]] [[lesion]]
* Atypical carcinoid
** Squamous cell carcinoma in situ
 
|-
====Other tumors that may affect the lungs====
! colspan="2" style="background: #707070; color: #FFFFFF; text-align: center;" |'''Neuroendocrine tumors'''
=====Salivary gland tumors=====
|-
* Mucoepidermoid carcinoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Small cell carcinoma of the lung|Small cell carcinoma]]'''
|
* Combined [[Small cell carcinoma of lung|small cell 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 of the lung|large cell neuroendocrine carcinoma]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Carcinoid syndrome|Carcinoid tumors]]'''
|
*[[Carcinoid tumor|Typical carcinoid tumor]]
*[[Carcinoid tumor|Atypical carcinoid tumor]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Pre-[[Invasive (medical)|invasive]] [[lesion]]'''
|
*[[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
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Adenosquamous carcinoma]]'''
|
* N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Sarcomatoid carcinoma of the lung|Sarcomatoid carcinomas]]'''
|
*[[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
* Adenoid cystic carcinoma
* Epithelial-myoepithelial carcinoma
*[[Epithelium|Epithelial]]-[[myoepithelial]] [[carcinoma]]
* Preinvasive lesions
*[[Pleomorphic adenoma]]
:* Squamous carcinoma in situ
|-
:* Atypical adenomatous hyperplasia
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Papilloma|Papillomas]]'''
:* Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia
|
 
*[[Squamous cell papilloma]]
=====Mesenchymal tumors=====
** Exophytic
* Epithelioid haemangioendothelioma
** Inverted
* Angiosarcoma
*[[Gland|Glandular]] [[papilloma]]
* Pleuropulmonary blastoma
* Mixed [[squamous]] and [[Gland|glandular]] [[papilloma]]
* Chondroma
|-
* Congenial peribronchial myofibroblastic tumor
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Adenoma|Adenomas]]'''
* Diffuse pulmonary lymphangiomatosis
|
* Inflammatory myofibroblastic tumor
* Sclerosing pneumocytoma
* Lymphangioleiomyomatosis
*[[Alveolar]] [[adenoma]]
* Synovial sarcoma
*[[Papilla|Papillary]] [[adenoma]]
* Pulmonary artery sarcoma
*[[Mucinous cystadenoma]]
* Pulmonary vein sarcoma
*[[Mucous gland]] [[adenoma]]
 
|-
=====Benign Epithelial Tumors=====
! colspan="2" style="background: #707070; color: #FFFFFF; text-align: center;" |'''Mesenchymal tumors'''
* Papillomas
|-
:* Squamous cell papilloma (either exophytic or inverted)
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hamartoma|'''Pulmonary hamartoma''']]
:* Glandular papilloma
|
:* Mixed squamous cell and glandular papilloma
* N/A
* Adenomas
|-
:* Alveolar adenoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Chondroma]]'''
:* Papillary adenoma
|
:* Adenomas of the salivary gland type
* N/A
::* Mucous gland adenoma
|-
::* Pleomorphic adenoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[PEComa|PEComatous tumors]]'''
::* Others
|
:* Mucinous cystadenoma
* [[Lymphangiomyomatosis|Lymphangioleiomyomatosis]]
 
* [[PEComa]] (benign)
=====Lymphoproliferative Tumors=====
**[[Clear cell tumor]]
* Marginal zone B-cell lymphoma of the MALT type
*[[PEComa]] ([[malignant]])
* Diffuse large B-cell lymphoma
|-
* Lymphomatoid granulomatosis
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Congenital peribronchial myofibroblastic tumor'''
* Langerhans cell histiocytosis
|
 
* N/A
=====Miscellaneous Tumors=====
|-
* Hamartoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Diffuse [[Lung|pulmonary]] [[lymphangiomatosis]]'''
* Sclerosing hemangioma
|
* Clear cell tumor
* N/A
* Germ cell tumors
|-
:* Teratoma, mature
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Inflammation|Inflammatory]] [[Myofibroblast|myofibroblastic]] [[tumor]]'''
:* Immature
|
:* Other germ cell tumors
* N/A
* Intrapulmonary thymoma
|-
* Melanoma
| 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==

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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