Non small cell lung cancer pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Non-small cell lung cancer arises from the epithelial cells of the lung of the central bronchi to terminal alveoli, which are normally involved in the protection of the airways. Non-small cell lung cancer is an invasive and rapidly growing cancer which may metastasize to different organs of the body. Genes involved in the pathogenesis of non-small cell lung cancer include EGFR, KRAS, HER2, BRAF, and ALK. On gross pathology, findings will depend on the histological type. On microscopic histopathological analysis non-small cell lung cancer demonstrate large cells with abundant cytoplasm and no stippled chromatin.

Pathogenesis

• Non-small cell lung cancer arises from the epithelial cells of the lung of the central bronchi to terminal alveoli, which are normally involved in the protection of the airways.
• Non-small cell lung cancer is an invasive and rapidly growing cancer which may metastasize to different organs of the body.

Genetics

• Development of non small cell lung cancer is the result of multiple genetic mutations.
• Genetic mutations play an important role in the treatment selection for non small cell lung cancer.
• Genes involved in the pathogenesis of non small cell lung cancer include:

Genes	Presence in non small cell-lung cancers
EGFR	EGFR mutations are present in approximately 10% to 15% of all non-small cell lung cancers
KRAS	Mutations are present in approximately 30% of pulmonary adenocarcinomas Mutations are present in approximately 5% of pulmonary squamous cell carcinomas Associated with carcinomas with mucinous histology
ALK	Mutations are present in approximately 5% of all non-small cell lung cancers
HER2	Mutations are present in approximately 4% of adenocarcinomas
BRAF	Mutations are present in less than 2% of adenocarcinomas
ROS-1	Mutations are present in less than 2% of adenocarcinomas

Associated Conditions

Non small cell lung cancer is associated with other conditions that include:

Gross Pathology

• On gross pathology, findings include:

Microscopic Pathology

• Shown below is a series of microscopic images observed in non small cell lung cancer:

References

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