Non small cell lung cancer classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2] Maria Fernanda Villarreal, M.D. [3]

Overview

Non-small cell lung cancer may be classified according to the WHO histological classification system into 3 main types: squamous cell carcinoma, lung adenocarcinoma, and large cell carcinoma. Other less common subtypes, include: adenosquamous lung carcinoma, pulmonary sarcomatoid carcinoma, carcinoid tumors of lung, and carcinomas of the lung of salivary gland type.

Classification

• There are 3 main types of non–small cell lung cancer: adenocarcinoma, squamous cell carcinoma and large cell carcinoma.
• The table below summarizes the WHO histological classification system for non small cell lung cancer.

WHO histological classification system Adapted from WHO/IARC (2006)
Main types	Subtypes	Prevalence
Adenocarcinoma	Adenocarcinoma, mixed 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	40% of lung cancers
Squamous cell carcinoma	Papillary Clear cell Small cell Basaloid	25% of lung cancers
Large cell carcinoma	Large cell neuroendocrine carcinoma Basaloid carcinoma Lymphoepithelioma-like carcinoma Clear cell carcinoma Large cell carcinoma with rhabdoid phenotype	10% of lung cancer
Less common types
Adenosquamous carcinoma	No subtypes	Less than 5%
Sarcomatoid carcinoma	Pleomorphic carcinoma Spindle cell carcinoma Giant cell carcinoma Carcinosarcoma Pulmonary blastoma	Less than 5%
Carcinoid tumor	Typical carcinoid Atypical carcinoid	Less than 5%
Salivary gland tumor	Mucoepidermoid carcinoma Adenoid cystic carcinoma Epithelial-myoepithelial carcinoma	Less than 5%

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