Lung cancer classification
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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., M.P.A., Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA, Cafer Zorkun, M.D., Ph.D. [2]
Overview
The vast majority of lung cancers are carcinomas—malignancies that arise from epithelial cells. There are two main types of lung carcinoma, categorized by the size and appearance of the malignant cells seen by a histopathologist under a microscope: non-small cell (80.4%) and small-cell (16.8%) lung carcinoma.[1] This classification, based on simple histological criteria, has important implications for clinical management and prognosis of the disease.
Classification
- Primary lung cancer can be classified into two main categories: small cell lung cancer (SCLC)(~15%) and non small cell lung cancer (NSCLC) (~85%).
- There are three main sub-types of NSCLC, which are grouped together because their prognosis and management are similar.:
- Squamous cell carcinoma (25% of lung cancers)
- Adenocarcinoma (40% of lung cancers) and large cell lung carcinoma (10% of lung cancers)
- Large cell carcinoma (10% of lung cancers)
- A subtype of adenocarcinoma, the bronchioloalveolar carcinoma, is more common in female never-smokers, and may have different responses to treatment.[2]
WHO Histological Classification of Tumors of the Lung [3]
Malignant Epithelial Tumors
- Squamous cell carcinoma
- Papillary
- Clear cell
- Small cell
- Basaloid
- Small cell carcinoma
- Combined small cell carcinoma
- Adenocarcinoma
- Adenocarcinoma, mixed subtype
- 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
- Large cell carcinoma
- Large cell neuroendocrine carcinoma
- Combined large cell neuroendocrine carcinoma
- Basaloid carcinoma
- Lymphoepithelioma-like carcinoma
- Clear cell carcinoma
- Large cell carcinoma with rhabdoid phenotype
- Adenosquamous carcinoma
- Sarcomatoid carcinoma
- Pleomorphic carcinoma
- Spindle cell carcinoma
- Giant cell carcinoma
- Carcinosarcoma
- Pulmonary blastoma
- Carcinoid tumor
- Typical carcinoid
- Atypical carcinoid
- Salivary gland tumors
- Mucoepidermoid carcinoma
- Adenoid cystic carcinoma
- Epithelial-myoepithelial carcinoma
- Preinvasive lesions
- Squamous carcinoma in situ
- Atypical adenomatous hyperplasia
- Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia
- Mesenchymal tumors
- Epithelioid haemangioendothelioma
- Angiosarcoma
- Pleuropulmonary blastoma
- Chondroma
- Congenial peribronchial myofibroblastic tumor
- Diffuse pulmonary lymphangiomatosis
- Inflammatory myofibroblastic tumor
- Lymphangioleiomyomatosis
- Synovial sarcoma
- Monophasic
- Biphasic
- Pulmonary artery sarcoma
- Pulmonary vein sarcoma
Benign Epithelial Tumors
- Papillomas
- Squamous cell papilloma
- Exophytic
- Inverted
- Glandular papilloma
- Mixed squamous cell and glandular papilloma
- Adenomas
- Alveolar adenoma
- Papillary adenoma
- Adenomas of the salivary gland type
- Mucous gland adenoma
- Pleomorphic adenoma
- Others
- Mucinous cystadenoma
Lymphoproliferative Tumors
- Marginal zone B-cell lymphoma of the MALT type
- Diffuse large B-cell lymphoma
- Lymphomatoid granulomatosis
- Langerhans cell histiocytosis
Miscellaneous Tumors
- Harmatoma
- Sclerosing hemangioma
- Clear cell tumor
- Germ cell tumors
- Teratoma, mature
- Immature
- Other germ cell tumors
- Intrapulmonary thymoma
- Melanoma
Metastatic Tumors
- The lung is a common organ for metastasis from tumors in other parts of the body. These cancers are identified by the site of origin, thus a breast cancer metastasis to the lung is still known as breast cancer. They often have a characteristic round appearance on chest x-ray.[4]
References
- ↑ Travis, WD (Jan 1995). "Lung cancer". Cancer. 75 (Suppl. 1): 191–202. PMID 8000996. Unknown parameter
|coauthors=ignored (help) - ↑ Raz, DJ (Mar 2006). "Bronchioloalveolar carcinoma: a review". Clinical Lung Cancer. Cancer Information Group. 7 (5): 313–322. PMID 16640802. Unknown parameter
|coauthors=ignored (help) - ↑ Travis, William (2004). Pathology and genetics of tumours of the lung, pleura, thymus, and heart. Lyon: IARC Press. ISBN 9283224183.
- ↑ Seo, JB (2001). "Atypical pulmonary metastases: spectrum of radiologic findings". Radiographics. 21 (2): 403–417. PMID 11259704. Retrieved 2007-09-10. Unknown parameter
|coauthors=ignored (help)