Small cell carcinoma of the lung overview: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
Small cell lung cancer is the most aggressive form of [[lung cancer]] and has the highest association with [[smoking]] of all lung cancers. Small cell lung cancer usually starts in the [[bronchi]] and expands through the [[bronchial]] [[mucosa]]. Small cell lung cancer often [[metastasize]]s rapidly to other parts of the body, including the [[brain]], [[liver]], and [[bone]]. A [[mutation]] in the [[p53]] [[gene]] is reported in 75%-100% of the cases. Other [[molecular]] abnormalities that contribute to the development of small cell lung cancer have been described. | |||
==Causes== | ==Causes== | ||
Revision as of 19:49, 29 April 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Small Cell Carcinoma of the Lung Microchapters |
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Differentiating Small Cell Carcinoma of the Lung from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Small cell carcinoma of the lung overview On the Web |
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American Roentgen Ray Society Images of Small cell carcinoma of the lung overview |
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Directions to Hospitals Treating Small cell carcinoma of the lung |
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Risk calculators and risk factors for Small cell carcinoma of the lung overview |
Overview
Small cell carcinoma of the lung is an anaplastic, highly malignant, and usually bronchogenic carcinoma composed of small ovoid cells with scanty neoplasm. It is characterized by a dominant, deeply basophilic nucleus, and absent or indistinct nucleoli. There are admixtures of small cell lung carcinoma with other types of lung cancer. Small cell carcinomas are distinguished by their distinctive biological features, response to chemotherapy and radiotherapy, and by their nearly universal tendency to develop overt or subclinical metastases, which frequently eliminates surgery in most patients.
Without treatment, small cell lung cancer (SCLC) has the most aggressive clinical course of any type of pulmonary tumor, with median survival from diagnosis of only 2 to 4 months. Compared with other cell types of lung cancer, SCLC has a greater tendency to be widely disseminated by the time of diagnosis but is much more responsive to chemotherapy and radiation therapy.
Because patients with small cell lung cancer tend to develop distant metastases, localized forms of treatment, such as surgical resection or radiation therapy, rarely produce long-term survival. With incorporation of current chemotherapy regimens into the treatment program, however, survival is unequivocally prolonged, with at least a 4- to 5-fold improvement in median survival compared with patients who are given no therapy. Furthermore, about 10% of the total population of patients remains free of disease during 2 years from the start of therapy, the time period during which most relapses occur. Even these patients, however, are at risk of dying from lung cancer (both small- and non-small cell types). The overall survival at 5 years is 5% to 10%.
Historical Perspective
Laennec first recognized lung cancer as a separate disease in 1815, in his work "Encephaloides" published in the Dictionnaire des sciences médicales. Azzopardi, in 1959, distinguished small cell lung cancer (SCLC) from anaplastic adenocarcinoma and squamous cell carcinoma and described the clinical and biological features that characterize it as a separate disease.
Classification
Pathophysiology
Small cell lung cancer is the most aggressive form of lung cancer and has the highest association with smoking of all lung cancers. Small cell lung cancer usually starts in the bronchi and expands through the bronchial mucosa. Small cell lung cancer often metastasizes rapidly to other parts of the body, including the brain, liver, and bone. A mutation in the p53 gene is reported in 75%-100% of the cases. Other molecular abnormalities that contribute to the development of small cell lung cancer have been described.