Small cell carcinoma of the lung laboratory tests: Difference between revisions
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===Biopsy=== | ===Biopsy=== | ||
The confirmation of the diagnosis of SCLC relies on the histopathological findings of the tumor [[biopsy]]. | The confirmation of the diagnosis of SCLC relies on the histopathological findings of the tumor [[biopsy]]. | ||
In SCLC, the tumor cells are small and round, but they can sometimes be ovoid or spindle shaped. They have a scant [[cytoplasm]] with a high mitotic count and a hyperchromatic [[nuclei]]. Nearly all SCLC are immunoreactive for [[keratin]], [[thyroid transcription factor 1]], and epithelial membrane antigen. Neuroendocrine and neural differentiation result in the expression of molecules like dopa decarboxylase, [[calcitonin]], neuron-specific [[enolase]], [[chromogranin A]], [[CD56]] (also known as nucleosomal histone kinase 1 or neural-cell adhesion molecule), gastrin-releasing peptide, and [[insulin-like growth factor 1]]. One or more markers of neuroendocrine differentiation can be found in approximately 75% of SCLC.<ref name="NCI"> National Cancer Institute: PDQ® Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/healthprofessional.</ref> | |||
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<gallery heights="175" widths="175"> | |||
Image:Lung small cell carcinoma (1) by core needle biopsy.jpg|Histopathologic image of small cell carcinoma of the lung. CT-guided core needle biopsy. H & E stain. | |||
Image:Lung small cell cancer 01.jpeg|Micrograph of a small-cell carcinoma of the lung showing cells with nuclear molding, minimal amount of cytoplasm and stippled chromatin. FNA specimen. Field stain. | |||
Image:Lung small cell cancer 03.jpeg|Anaplastic (microcellular, oat cell) carcinoma from the lung. | |||
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<gallery heights="175" widths="175"> | |||
Image:Lung small cell cancer 04.jpeg|Histopathologic image of small-cell carcinoma of the lung. CT-guided core needle biopsy. | |||
Image:Lung small cell cancer 05.jpeg|Small cell carcinoma, pleural FNA. | |||
</gallery> | |||
</div> | |||
===Laboratory Tests=== | ===Laboratory Tests=== | ||
Revision as of 12:56, 19 June 2014
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Small Cell Carcinoma of the Lung Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The initial evaluation of patients with small cell lung cancer (SCLC) confirmed by histopathological findings include a complete blood count with differential, electrolytes, liver function test, calcium level, LDH, BUN, and creatinine.[1] These laboratory tests should also be performed to assess the response to the initial therapy.[1]
Laboratory Findings
Biopsy
The confirmation of the diagnosis of SCLC relies on the histopathological findings of the tumor biopsy.
In SCLC, the tumor cells are small and round, but they can sometimes be ovoid or spindle shaped. They have a scant cytoplasm with a high mitotic count and a hyperchromatic nuclei. Nearly all SCLC are immunoreactive for keratin, thyroid transcription factor 1, and epithelial membrane antigen. Neuroendocrine and neural differentiation result in the expression of molecules like dopa decarboxylase, calcitonin, neuron-specific enolase, chromogranin A, CD56 (also known as nucleosomal histone kinase 1 or neural-cell adhesion molecule), gastrin-releasing peptide, and insulin-like growth factor 1. One or more markers of neuroendocrine differentiation can be found in approximately 75% of SCLC.[2]
-
Histopathologic image of small cell carcinoma of the lung. CT-guided core needle biopsy. H & E stain.
-
Micrograph of a small-cell carcinoma of the lung showing cells with nuclear molding, minimal amount of cytoplasm and stippled chromatin. FNA specimen. Field stain.
-
Anaplastic (microcellular, oat cell) carcinoma from the lung.
_by_core_needle_biopsy.jpg)
-
Histopathologic image of small-cell carcinoma of the lung. CT-guided core needle biopsy.
-
Small cell carcinoma, pleural FNA.
Laboratory Tests
The following laboratory tests must be ordered in all patients with SCLC during the initial evaluation and for the assessment of response to treatment following the initial therapy:[1]
- Complete blood count with differential
- Electrolytes
- Liver function test
- LDH
- Calcium level
- BUN
- Creatinine
References
- ↑ 1.0 1.1 1.2 NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014
- ↑ National Cancer Institute: PDQ® Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/healthprofessional.