Histological type of esophageal cancer

The vast majority of esophageal cancer occurred in esophageal mucosa, a small number of sources in the leaf tissue sarcoma embryo. Esophageal cancer in more than 95% of squamous cell carcinoma, a small number of ectopic origin of the esophageal glands or gastric adenocarcinoma, squamous cell and adenocarcinoma occasionally combined with a cancer in the gland or gland carcinoma gland cancer known as squamous metaplasia and spine cancer.
Histological type of esophageal cancer (1) squamous cell carcinoma: esophageal cancer accounts for more than 90%, occurred in the esophageal squamous epithelium, can be found in any part of the esophagus, but in the middle of the esophagus, followed by the next paragraph. Polygonal cells, cell borders clearly, and sometimes the bridge can be seen between cells. Located in the central nucleus of cells, were round or oval, showing mitotic cancer cells showed a nested structure, with varying degrees of differentiation, the formation of cancer and some beads, visible central keratinized cancer nest.
Histological type of esophageal cancer (2) Cancer: Esophageal adenocarcinoma is less common, and more from the esophageal gland, a small number of disease from ectopic gastric mucosa, the formation of pure cubic adenocarcinoma cells were cylindrical, nuclear were round, oval or rod-shaped, and the cell diameter parallel. Coarse nuclear chromatin, cell differentiation by different degrees of glandular-like structures. Another showed adenocarcinoma of the esophagus associated with adenocarcinoma squamous cell carcinoma, can be the bridge between horned into cells, cancer cells was cubic or cylindrical form, the proportion of adenocarcinoma and squamous cell cancer due to different cases or tumor place to another. If the main well differentiated cancer, and small pieces adenocarcinoma cancer cell nests surrounded by very close with squamous metaplasia, known as glandular spine cancer, the third esophageal adenocarcinoma adenoid cystic carcinoma , this type is less common cancer was basal cell-like, composed of glandular sizes, such as sieve-like.
Histological type of esophageal cancer (3) Small cell undifferentiated carcinoma: a more rare for the esophageal cancer, cancer cells as small round cell or pleomorphic cells, scarce cytoplasm, chromatin stained nucleolus is not Ching, tumor cells were arranged in sheets or conflict of rules nested. A high degree of malignancy of this type.
Histological type of esophageal cancer (4) Sarcoma: from epithelial or mesenchymal tumor tissue sub-variable, multi-located in the lower esophageal tumor tissue, there are two components in the tumor tissue distribution of cancer in which the surface of many cancer cells as well differentiated squamous cell carcinoma, a small number of undifferentiated carcinoma, adenoid cystic basal cell carcinoma as tumor. Sarcoma, spindle cell components and more often for the giant cell tumor of mixed malformations. Occasional smooth muscle, cartilage, bone-like tissue into a similar striated muscle sarcoma. This type of cancer is generally believed that a better prognosis.
In addition, the pathological often based on the progress of esophageal cancer type. Can be divided into: intraepithelial carcinoma or carcinoma in situ: epithelial cells occupied the whole layer, but the basement membrane integrity. mucosa into the early invasive cancer: carcinoma in situ, or involving a small number of cells have invaded the lamina propria, but did not penetrate the muscularis mucosa, invasive minimal. submucosal carcinoma or early invasive carcinoma: Pat cancer cells through muscularis mucosa into the submucosa, but not involving the muscle layer, no lymph node metastasis. advanced esophageal cancer: the cancer has penetrated the lower esophageal mucosa, or esophageal full-thickness myometrial invasion, and even the surrounding tissue, there are varying degrees of lymph node metastases.

Advanced gastric pathological classification of section

Carcinoma infiltrating into the submucosa are less advanced gastric cancer , or known in advanced gastric cancer. The deeper the cancer, the worse the prognosis, invasion to serosa than 5-year survival rate; invasion to the muscular layer of the significantly reduced.
Advanced gastric pathological type of segment, the current widely used international classification of Borrmann's gross. Borrmann according to the form of cancer in the mucosal surface and in the way of infiltrating the stomach is divided into four types: I type is protruding, II ulcerative type is limited, Tian infiltrating ulcerative type, N-type diffuse infiltrative. Pathological Cooperative Group of gastric cancer are justified on the basis of the Borrmann further divided into the following types of gastric cancer.
Advanced gastric pathological type of paragraph (1) nodular Evil Umbrella: tumor was nodular, polypoid or papillary broke into the stomach, gastric cancer and the surrounding clear boundaries. Surface often superficial necrosis or ulcer formation. This type of a considerable period of time often remain in the shallow parts of the stomach, a long time before progress to the deeper gastric wall, mostly histologically well-differentiated adenocarcinoma.
(2) discoid grass umbrella: the cancer was discoid uplift in the mucosal surface, the surface of the tumor deep edge of anger War from valgus high, cut line clear.
(3) limited customary War type: cancer has obvious anger surfaces War, ulcer diameter from lcm ~ lOcm or more, often deep ulcer at the end muscle, ulcer-like uplift dike edges, but the irregular edge of the bottom not smooth. Cancer around the boundary more clearly.
Advanced gastric pathological type of paragraph (4) Shame stain infiltrating type: cancer ulcer edge also elevated, but was sloping, and with the film around to account for ill-defined, infiltrative growth pattern, and this is limited The main difference between ulcerative.
(5) limit invasive: invasive cancer was the growth of the surrounding surface may have erosion or ulcer formation.
(6) diffuse infiltrative: Features of gastric tumor cavity was not seen, but diffuse gastric wall thickening to a significant, often exceeding 2cm. This type of microscope, one for the signet ring cell carcinoma or poorly differentiated adenocarcinoma in the submucosa or muscularis extensive infiltrative growth and caused a large number of fibrous connective tissue reaction, so that the stomach wall thickening, hardening, narrowing the stomach cavity, it is also known Phascolosoma stomach.
(7) Surface diffusion: cancer mainly in the mucosa or submucosa infiltration. Wider, but a small part of the muscle layer or myometrium is invaded outside, so it is not superficial early gastric cancer of superficial localized or diffuse.
(8) mixed type: the type of mixing two or more persons.
Advanced gastric pathological type of paragraph (9) Multiple cancer: Refers to the stomach in the same place more than two multiple foci, and disconnected.


  • Borman classification of advanced gastric cancer

Lung pathology in major types of lung cancer

Shape from the naked eye, according to the site of tumor, gross type of lung cancer is divided into central, peripheral, and pleural diffuse type, in which the three previously common, pleural type less.
Lung pathology in major types of lung cancer 1. Central lung cancer (centre type) that the hilar type (hilar type) of lung cancer. Tumors occurred in the main bronchus, lobar bronchus and bronchial above paragraph. Tumor also extended along the bronchial wall and bronchial wall damage, peribronchial infiltration of lung tissue, the occurrence of bronchial lymph nodes, hilar lymph nodes, or even mediastinal lymph nodes enlarged lymph nodes and the formation of large primary tumor mass, its distal lung tissue occur more obstructive pneumonia. Common tumor necrosis gross specimen of the cut surface bleeding, and sometimes a small hole formed. Central lung cancer, 2 / 3 belong to order cancer. Early multi-cough, bloody sputum and other clinical symptoms, but often not timely treatment of patients can not seriously, when there is chest pain, hoarseness and other symptoms, the tumor had been violations of the surrounding lymph nodes and mediastinum, forming a large nodule or mass , loss of surgical treatment.
According to tumor morphology and growth patterns, the early and central two subtypes:
(1) tube type: This type of lung cancer tumors spread along the bronchial stalk membrane, leading to thickening of bronchial mucosa, despite infiltration of the bronchial wall, but still intact. Bronchial tumor confined within the lumen sudden, granular, papillary or polypoid. Extensive use of bronchoscopy, which greatly improves the rate of these early lesions.
(2) infiltrating the wall: tumor occurrence was part of the trachea wall thickening, bronchial wall damage not only cancer but also infiltrating the surrounding lung tissue, but not invading the hilar lymph nodes, etc.. Can be clearly shown on the cut surface of tumor bronchial lesions usually less than 2cm.
Lung pathology in the 2 main types of lung cancer. peripheral lung cancer (Peripheral type) in peripheral lung cancer in the following section of the small bronchi. Subpleural lung cancer in the surrounding. Single nodules were more common, but also for multiple nodules. Section of tumor nodules are pale, often accompanied by hemorrhagic necrosis, and the surrounding lung tissue boundaries more clearly, occasionally to be invasive in the bronchi.
According to the tumor volume, peripheral lung cancer were divided into ball and block type.
(1) ball: size is generally small, maximum diameter less than 3cm, clear boundaries with the surrounding lung tissue and bronchial no specific relationship between the tumor edge and sometimes lobulated.
(2) block type: a large spherical volume than the maximum diameter of more than 3cm, and the surrounding lung tissue is sometimes unclear boundaries, irregular mass, we can see varying degrees of necrosis.
Peripheral lung cancer, mostly cancer, more common in women. Early clinical symptoms was not obvious because, it is mostly accidental or physical examination finder. Easy to violations of the pleura, causing chest pain and malignant pleural effusion.
Lung pathology 3 main types of lung cancer. Mi Baptist lung cancer (diffuse type) and more diffuse type of lung cancer occurred in the bronchioles or alveoli, can affect both lungs. Most of the tumor occupied a large leaf or the entire large leaves, diffuse infiltration, it is also known as pneumonia, alveolar cell carcinoma, the lesion develops slowly, and clinical pulmonary fibrosis should be, or interstitial pneumonia be differentiated.
Lung pathology in 4 main types of lung cancer. Pleural lung (pleural type) primary tumor may have originated in the bronchioles, extensive infiltration of the pleura, the visceral and parietal pleura caused extensive adhesions, fusion, pleural involvement can be 1-2cm thick . Most of this type of poorly differentiated adenocarcinoma. Lung cancer diagnosis of pleural very difficult, not only difficult clinical diagnosis, pathological diagnosis is very difficult. General characteristics and chronic infection pleurisy, pleural mesothelioma and metastatic carcinoma is difficult to distinguish, the final diagnosis depends on histology and immunohistochemistry.
Central type of lung cancer, peripheral, diffuse, and pleural type, the former two common, diffuse rare type of pleural most rare.

Abnormal squamous cell lung cancer

Abnormal squamous cell carcinoma of the variation of the morphological structure, forming a variant of squamous cell carcinoma (variants). Include the following types: papillary type (papillary variant); small cell type (small cell variant); basal cell-like types (basaloid variant); clear cell type (clear cell variant). These variant of squamous cell carcinoma squamous cell carcinoma often in the focal form, but mostly two or more hybrid variant form, rarely used as a variant of the main cancer.
Abnormal squamous cell lung cancer (1) of papillary squamous cell carcinoma (squamous cell carcinoma, PaPillary variant): short papillary squamous cell carcinoma. Into poorly differentiated, moderately differentiated and well differentiated papillary carcinoma. As long as the tumor cells with sufficient atypia can be diagnosed as papillary carcinoma. Papillary carcinoma was the structure, ranging from papillary cell layers covered by the squamous cell differentiation of different composition; cancer cells have the characteristics of squamous differentiation, such as layered, with cells between keratinocytes and cell bridge. Most cells differentiated, layered structure is clear. Proximal large bronchi of the more common type; tumor growth was exogenous, papillary or polypoid; bronchial wall Street, the infiltration was not obvious. Of poorly differentiated and moderately differentiated papillary carcinoma, according to the pathology typical of Jane is not difficult to break. For well-differentiated papillary carcinoma, and more can always find a malignant features drawn, make a diagnosis. If it is a small sample drawn bronchoscopy, you must be careful! Because of bronchial squamous cell papilloma and difficult to identify.
Abnormal squamous cell lung cancer (2) small-cell squamous cell carcinoma (squamous cell carcinoma, small cell variant): referred to as small cell carcinoma. Are poorly differentiated squamous cell carcinoma.
This type of histological features: a. cell size is generally small, but still has the morphological characteristics of non-small cell carcinoma of the teams are relatively abundant cytoplasm, clear cell weekly community; c. relatively large nucleus, nuclear chromatin granules like, part of the cancer cells have significant nucleoli. cancer can occur within the typical keratinized cells or keratin pearls, intercellular bridges.
small cell lung carcinoma and small cell lung cancer compound in the differential diagnosis: small cell lung carcinoma and small cell lung cancer, small cell lung cancer compound (ie, small cell lung carcinoma and squamous cell composite) key is the identification of small cell characteristics. Small cell lung cancer small cell, with non-small cell carcinoma of the some of the characteristics of the cells is small, and relatively abundant cytoplasm; cell boundaries clear; a cell bridge; coarse granular nuclear chromatin, vacuolization; part of the cancer cells with prominent nucleoli. Immunohistochemical neuroendocrine markers, such as NSE, contact the grain element A (chromogranin A), synaptophysin and other negative reactions, or only scattered cells were weakly positive. Electron microscopy is difficult to find the neuroendocrine granules.
Abnormal squamous cell lung cancer (3) basaloid squamous cell carcinoma (squamous cell carcinoma, basaloid variant): referred to as basaloid squamous cell carcinoma, poorly differentiated squamous cell carcinoma is the lung.
Characteristics of basaloid squamous cell carcinoma: a. cancer nest with the morphological characteristics of squamous cell differentiation, showing cancer nest hierarchy, the central focal cancer nest cells, abundant cytoplasm, cell keratosis and (or) typical, not typical of the formation of keratin pearls, intercellular bridges cell appeared; b. surrounding cancer nests showed a typical nuclear palisading: cancer is small, less cytoplasm, hyperchromatic nuclei; c. clear boundary with significant fibrous stroma Reaction to pay. immunohistochemistry: Cancer of the low molecular weight cytokines (CK) was generally weak, the positive rate of up to 84%; positive rate of neuroendocrine markers, NSE was 28%. Chromogranin was 14%, strength is weak.
in the organizational structure and the basal cell-like large cell carcinoma in the differential diagnosis: two weeks of cell nests showed palisading, were similar. But still easy to identify: a. basaloid squamous cell carcinoma with squamous differentiation characteristics, and basal cell-like large cell carcinoma, squamous cell differentiation of the lack of morphological features; b. basaloid squamous cell carcinoma of the nest General Instrument small, interstitial fiber response was obvious; and large cell carcinoma, basal cell carcinoma-like nests larger, less fibrous tissue; c. large cell carcinoma, basal cell-like necrosis of the more obvious; and basal cell carcinoma showed a small focal necrosis.
Abnormal squamous cell lung cancer (4) characteristics of clear cell squamous cell carcinoma: cell cytoplasm is rich in water transparency, easy to find the special form of squamous cell differentiation in cancer cells as the main transparent, intermingled with squamous cell specific form of cancer, squamous cell carcinoma of the part of the cancer tissues were layered structure, cell differentiation, ranging from keratinized cells or cells can be the bridge between.
Differential Diagnosis: This type of diagnosis can lead to confusion in the main pulmonary clear cell carcinoma and cell carcinoma. The latter does not have a squamous cell differentiation based on morphological characteristics, this can be identified.

Squamous cell carcinoma of the lung peripheral

Peripheral pulmonary squamous cell carcinoma in peripheral lung squamous cell carcinoma, squamous cell carcinoma as target type (peripheral squamous cellcarcinoma), referred to as peripheral squamous cell carcinoma. Peripheral squamous cell lung cancer accounts for 7% of the total number of 14%.
(1) histological features and clinical: peripheral pulmonary squamous cell carcinoma of the age, sex, location, tumor size and organizational structure, and the central roughly the same. Size is generally small, but often accompanied by cavitation. Lung cancer with cavity formation, most of the histological type is squamous cell carcinoma. Characteristics of peripheral pulmonary squamous cell carcinoma as follows: fewer symptoms; well differentiated cancer cells, the majority belong to the differentiation of squamous cell carcinoma (SCC most central of squamous cell carcinoma is a low juice); invasion of lymphatic weak; hilar lymph node metastasis was low; at 5-year survival rate is higher.
(2) differential diagnosis:
squamous cell carcinoma of the lung peripheral adenocarcinoma of the identification and implementation of key points: a. whether the hierarchical structure: state of implementation of gonads showed no hierarchical structure; peripheral squamous cell carcinoma showed a hierarchical structure; b. the number of mucus: Real gonadal cancer, cancer cells secrete fluid is easy to see taught, and the secretion of peripheral squamous cell carcinoma but not new or occasional liquid; c. is easy to form a cavity: surgical resection specimens, voids form around the more common type of squamous cell carcinoma, and solid adenocarcinoma necrosis, but less than the formation of voids.
peripheral pulmonary squamous cell carcinoma and large cell carcinoma, identification of key points: a. basal cell-like large cell carcinoma, although the nest week also showed a palisade cells, but the hierarchy is not obvious, and the peripheral squamous cell carcinoma of the sub-nest layer structure significantly; b. peripheral squamous cell nests can always find the central keratinization, and even the formation of a large number of keratosis, and basal cell-like large cell carcinoma cells is not display the morphological characteristics; c. large cell carcinoma, basal cell-like mitotic index is high, the average 70/10HPF, the mitotic index was lower in peripheral squamous cell carcinoma, the average 24/10HPF; d. basal cell-like large cell carcinoma, mostly large necrosis, and peripheral squamous cell carcinoma often has small focal necrosis; e. like large cell carcinoma, basal cell necrosis section bleeding obvious, and common cavity formation of peripheral squamous cell carcinoma.

Overview of small cell lung cancer

General overview of small cell lung cancer, small cell lung cancer is the lung (bronchial) epithelium highly malignant, undifferentiated, with neuroendocrine differentiation of cancer. Cancer is small; cytoplasm less ill-defined cells; was slightly granular chromatin, no nucleolus or nucleoli was not significant; fission common.
Small cell lung cancer is highly malignant cancer with neuroendocrine differentiation. Clinical development of rapid, widespread infiltration and metastasis. General overview of small cell lung cancer, the clinical course of less than 3 months. Cough is the most common clinical symptoms of patients, about 75% of patients; followed by chest pain. Small cell lung cancer, the rapid spread of the cancer, surgical resection most patients lose the opportunity; with small cell carcinoma sensitive to chemotherapy, so patients with small cell carcinoma is generally not surgery to remove, the use of chemotherapy and radiotherapy.
(1) general pathological features: small cell lung cancer mainly originated in the large bronchi, such as the lobar bronchus and segmental bronchi. Therefore, small cell lung cancer more than 90% in the hilar region (central type), more than 10% originated in the small bronchi, located in the peripheral lung (peripheral). Cancer grows fast, easy infiltration of the surrounding lung, hilar and mediastinal lymph nodes, forming a huge mass. Often the primary tumor area boundary more clearly, soft; section gray, often accompanied by a large sheet hemorrhage, necrosis, but rarely liquefied necrotic tissue dissolution of cavity formation. Bronchial mucosal lesions can be, so central small cell lung cancer patients, few clinical sputum or hemoptysis hemoptysis in patients with central type of squamous cell carcinoma are different.
(2) histological features: small cell carcinoma of the lung tissue structure is relatively complex, its structure and cell characteristics: diffuse infiltration of cancer tissue, cancer cells arranged in haphazard, mostly in films like Spansion, the middle of delicate fibrous tissue compartment; a small number of cancer cells was afraid of cancer nest-like arrangement and were fence-like structure of pericytes, which is the development of neuroendocrine differentiation like structure; cancer is small, typically round or oval cancer cells form brome ( 0111 ~ 0ll); cytoplasm less densely packed cells, unclear boundaries; clear nuclear outline was quickly fine granular chromatin; no obvious nucleolus or nucleoli; mitotic abnormalities live team.
(3) electron microscopy features: small cell lung cancer, the most important features of the ultrastructure was found in neurosecretory granules within cells: ultra-thin sections in a fixed good, its size does not exceed 200m; particles for the dense central core The most outer limiting membrane integrity in the core and return with a space between. Particles are spherical and relatively uniform shape, but in most cases, clustered in the cytoplasm of the secretory granules that condyle.
(4) Immunohistochemistry: commonly used in small cell lung cancer by immunohistochemistry as follows:
epithelial markers: a. cytokeratin (cytokeratin, CK): hi with a low molecular weight cytokeratins, such as CK8, CK18, CK19, etc., before staining with enzyme digestion, positive 10%, while the use of high molecular weight cytokeratin protein, without the enzyme digestion, the positive rate meter 8%; b. epithelial membrane antigen (EMA): The positive rate of about 50%.
neuroendocrine tests: small cell lung cancer by immunohistochemical methods, can detect more than the book version of the product of prime category, including multiple skin type and glue. Pathological diagnosis often applied in a variety like: a. Neuron specific enolase (neuron-specific enolase, NSE): probability of 50%. However, proof of clinical practice, NSE in neuroendocrine differentiation of the tumor more sensitive to the surface, but not specific; b. neurofilament (neurofilanlent, NF): the main chance of positive expression of 10%; c. wrong tablets hormone (chromogranin, Cg): including CgA and CgB, is inert protein. This marker although not sensitive, but highly specific neuroendocrine differentiation; d synaptophysin (synaptophysin, Svn): are membrane glycoprotein of neurons and neuroendocrine differentiation with high sensitivity and specificity. Positive in small cell lung cancer 20% -80% expression, while in non-small cell lung cancer, the positive rate was 3.8% -8%.
In addition, calcitonin (calcitonin), bell looking skin (bombesin), ACTH, and somatostatin (somatostatin) higher positive rates in small cell lung cancer and other identification have a certain significance.
(5) small cell lung cancer, changes in cell genetics: mainly for the chromosomal variation.
(6) differential diagnosis: small cell lung cancer in the diagnosis, should be addressed to small cell lung tumors.
carcinoid and atypical carcinoid tumors: part of the small cell lung cancer misdiagnosed as atypical carcinoid. Small cell lung carcinoma and carcinoid, atypical carcinoid tumors are the property of pulmonary neuroendocrine tumor, is a common lung cancer. In the differential diagnosis should be noted: a. SCLC is a highly malignant tumor, and carcinoid and atypical carcinoid tumors are low grade and intermediate grade. The former fast tumor progression, and soon spread occurrence, invasion and metastasis; the latter was clinically progressive, slow disease progression; b. carcinoid and atypical carcinoid tumor was a typical organ-like nest-like structure, daisy-shaped tumor cells arranged Mission, ribbon-like, cord-like, tubular-like, more homogeneous tumor cells. The SCLC cell density, deeply stained; c. SCLC different mitotic activity, the average mitotic counts> 801lOHPF, up to 200/10HPF; carcinoid nuclear fission <2/10HPF, atypical carcinoid mitotic 2-lO/lOHPF; d. SCLC more broadly, large necrosis; carcinoid tumors usually no necrosis, atypical carcinoid spotty necrosis; e. neuroendocrine immunohistochemical detection carcinoid, atypical carcinoid positive positive rate is much higher than the SCLC.
small cell lung cancer (SCLC) and pulmonary non-Hodgkin's lymphoma (NHL): a.SCLC with neuroendocrine organ-like nest-like structure, NHL tumor cells is more diffuse, uniform, does not have a specific structure; b.SCLC tumor cell arrangement is more intensive, more diverse forms; NHL tumor cells form a more homogeneous; c.SCLC large sheet was extensive necrosis, vascular wall basophilic, NHL does not have this change; d. rapid development of clinical SCLC, and soon occur far at the transfer; NHL develops slowly, and more distant metastasis; e.SCLC to cytokeratin and neuroendocrine-positive; NHL cell marker antibodies.
small cell squamous cell carcinoma (SSCC): SSCC low differentiation, cancer cells small, granular nuclear chromatin, cell morphology and the SCLC were similar. Identification, attention: a.SSCC cytoplasm of tumor cells showed more obvious nucleoli in total to find the squamous cell carcinoma tissue and cell hierarchy within the keratosis; and lack the characteristics of SCLC neuroendocrine tumors q. cloth organ-like nested structure, rosettes, ribbon-like, cord-like structure, urine, large basophilic necrosis and vascular wall; b. SSCC of epithelial markers generally strongly positive up to 97% -99%; the SCLC low molecular weight CK-positive, EMA positive d of only 50%; c. neuroendocrine labeling antibodies, LC compared with the SSCC, the positive rate was higher expression is also strong; d.SCLC clinical development SCC fast, distant metastasis also earlier; e.SCLC of chemotherapy, radiation sensitive, and SSCCill treatment of choice for the surgery.
(7) small cell lung cancer grade and stage: small cell lung carcinoma is an undifferentiated carcinoma, histopathology, no longer graded.
(8) general overview of small cell lung cancer, small cell lung cancer prognosis: although the tumor to chemotherapy, radiation sensitive, but the survival of about 2
years, so the prognosis is poor.

Compound described small cell lung cancer

Composite of small cell lung cancer (combined small carcinoma of the lung, CSCLC) refers to small cell lung cancer with any organizations, non-small cell carcinoma.
Compound described small cell lung cancer (1) histopathological characteristics and classification: non-small cell carcinoma should be characteristic of the structure, such as squamous cell carcinoma, adenocarcinoma and large cell carcinoma. In any non-small cell carcinoma with small cell carcinoma, small cell carcinoma of the content regardless of how much is attributable to compound small cell lung cancer.
Compound introduced small cell lung cancer, small cell carcinoma of the lung is divided into small cell carcinoma and combined small cell carcinoma, is WHO recommended classification. Common compound in the form of small cell carcinoma are: non-small cell carcinoma; small cell carcinoma and squamous cell carcinoma; small cell carcinoma accompanied by adenocarcinoma and squamous cell carcinoma; small cell carcinoma and large cell carcinoma, this is more a hybrid form rare.
Compound described small cell lung cancer (2) Diagnosis and differential diagnosis: complex of small cell carcinoma, the tumor tissue, non-small cell carcinoma and non-small cell carcinoma of the morphological characteristics, diagnosis is not difficult. But the diagnosis should be with the following tumors.
small cell squamous cell carcinoma (SSCC): This type of cancer are squamous cell carcinoma and small cell carcinoma, similar to small cell carcinoma combined small cell carcinoma and squamous cell complex. More typical squamous cell carcinoma, without identification. Focus on the identification of small cell parts. Small cell carcinoma of the small cell, larger, more cytoplasm; nucleoli more obvious, does not have nested neuroendocrine organ-like structure, and hierarchical structure with characteristics of squamous cell carcinoma.
large cell neuroendocrine carcinoma (LCNEC): This type of cancer with neuroendocrine differentiation of morphological characteristics, namely: with organ-like nests, cords, rosettes structure; electron microscopy and immunohistochemistry that neuroendocrine differentiation markers complex; large necrosis and high mitotic frequency. The similarities in the small cell carcinoma and large cell complex. LCNEC of the cancer cells but relatively large, abundant cytoplasm, nuclear vacuolization or slightly granular, often nucleolus or nucleoli evident. Small cell carcinoma of the compound in the large cell and small cell exist, which does not have a large cell neuroendocrine morphology and neuroendocrine differentiation markers; and small cells with neuroendocrine differentiation, although the morphological characteristics and neuroendocrine markers, However, compared with LCNEC cells, the cancer volume is small, nucleolus is not obvious.

Characteristics of lung cancer Introduction

Lung cancer (adenocarcinoma) is the lung (bronchial) epithelial cancer. Adenoid differentiation of tumor cells or cancer cells secrete mucus. Tumor tissue can be presented alveolar (acinar), papillary (papillary), bronchioloalveolar-like (bro with hioloalveolar), solid structure with mucus formation (solid with mucin formation) or the various types of mixing.
Adenocarcinoma of lung cancer histological types in common.
Prognosis of lung adenocarcinoma than squamous cell carcinoma is good, but slightly better than the small cell lung cancer. Poor prognosis of lung cancer, the early invasive cancer tissue to the blood vessels prone to distant metastasis. Second, because most are peripheral lung cancer early in patients without obvious clinical symptoms, it is a symptoms, most radical of the time lost. Lung cancer occurs mainly in the peripheral lung, occurred in the central area of lung is rare.
Characteristics of lung cancer described (1) general pathological features: peripheral lung cancer, accounting for 70% -80% of lung cancer, mainly in the bronchioles of less than 3mm. If the adjacent lung membrane, the fibers cause lung membrane thickness, shrinkage forming depression. Off-white tumor, according to the different mucus, plastic dolphin-like appearance; tumor may contain carbon dust, light brownish-black spots, while in the whole thing black. If the tumor is larger around the boundaries clear, star-shaped infiltration of the lungs, the central area of necrosis often easy to trace the formation of epilepsy, but rarely form a hollow.
Characteristics of lung cancer described (2) under the electron microscope the main thing in common lung cancer: performance of the external cavity with cells, intracellular mucus granules; may have secretion phenomenon, well-developed endoplasmic reticulum, Golgi complex and the aircraft body, occasionally desmosomes, but no tension of the original fibers.
Characteristics of lung cancer described (3) immunohistochemistry: Cancer of the CEA response was stronger than cytokeratin (CK). According to the information, adenocarcinoma was 100% CEA, cytokeratin, 63.2%, this difference is significant.
Characteristics of lung cancer described (4), histological type: the more complex structure of lung cancer, according to WHO (1999) outside the histological classification of lung cancer can be divided into five subtypes and five variants.
Characteristics of lung cancer described (5), histological grade of adenocarcinoma: lung cancer among different types often mixed with each other, that is, the same histological type of differentiation may also be present in varying degrees. According to the degree of cell differentiation and tissue structural characteristics of the lung is divided into adenocarcinoma, moderately differentiated adenocarcinoma and poorly differentiated adenocarcinoma. Such as bronchioloalveolar carcinoma, differentiated fetal adenocarcinoma, mucinous (colloid) adenocarcinoma, mucinous cystadenocarcinoma is well differentiated adenocarcinoma; and solid adenocarcinoma with mucus formation, cell carcinoma and clear cell carcinoma to belong to the low differentiated adenocarcinoma.


  • star shaped spot on lung
  • star shaped lung cancer
  • star shaped nodule on lung
  • starshaped in lungs

Variant of large cell carcinoma – large cell carcinoma with rhabdoid phenotype

Variant of large cell carcinoma – large cell carcinoma with rhabdoid phenotype: the type of cancer cells was eosinophilic intracytoplasmic inclusion bodies with large cell carcinoma, a rare case.
the naked eye: the tumor border is unclear. Section gray-brown, often accompanied by focal hemorrhage and necrosis.
microscope: cell nucleus large, vacuolization, prominent nucleoli. Part of the cancer cell nucleus deviation. Diffuse distribution of cells, clear state. Morphological features with diagnostic significance is the large cell carcinoma of the part or most (at least 10%) cancer cells rich in cytoplasm, eosinophilic, and large round education strong eosinophilic inclusion body.
variant of large cell carcinoma – large cell carcinoma with rhabdoid phenotype electron microscopy: cell cytoplasm is rich in glycogen particles, while the light microscope, the strong eosinophilic inclusion bodies to intermediate filaments in the electron microscope. Visible cell processes of individual cases of cancer and cause the core particles land, namely neuroendocrine differentiation.
Special staining: a rhabdoid phenotype in tumor cells. Without amylase treatment, positive staining; after amylase treatment, were negative. Confirmed that contain sugar, but the cytoplasm of eosinophilic inclusion bodies PAS staining was negative.
immunohistochemistry: a result of cell cytoplasm containing abundant intermediate filaments, gas immunohistochemical staining, cells could simultaneously express vimentin, EMA and cytokeratin, but myogenic standard, antibodies [such as actin (actin) , myoglobin (myoglobin) and HHF-35, etc.]; the negative. If the tumor neuroendocrine differentiation occurs, can be presented NSE, chromogra11111 and synaptophysin positive.
variant of large cell carcinoma – large cell carcinoma with rhabdoid phenotype differential diagnosis
a. Carcinosarcoma: The difference is that the latter two components varied, the composition of cancer, including squamous cell carcinoma, sarcoma of the ingredients are mostly two or more, including fiber, nerve, muscle, bone, bone, animal husbandry. If the mother striated muscle cells, myoglobin immunohistochemistry (myogfobin), medium protein (desmin) was positive.
b. malignant melanoma: malignant melanoma cells can be seen with varying amounts of black particles, if necessary, immunohistochemistry, malignant melanoma cells S-100 protein HIIlMB-45-positive, these are associated with large cell carcinoma with rhabdoid table type are different.
The large cell carcinoma with rhabdoid phenotype and the identification of other tumors, according to Zheng and immunohistochemical tissue staining, is not difficult to identify.
prognosis: the strong invasion and poor prognosis.

Variant of large cell carcinoma – clear cell carcinoma

Variant of large cell carcinoma – clear cell carcinoma (clear cell carcinoma): as an independent type of lung cell carcinoma is extremely rare.
the naked eye: tumors are peripheral, tumor boundaries with the surrounding lung tissue is unclear, the size of one. Grayish yellow cut surface, may be associated with hemorrhage and necrosis.
variant of large cell carcinoma – clear cell carcinoma of the microscope: a characteristic of tumor cells are large polygonal cytoplasm translucent (waIl'r-dear) or a foam. Within the cytoplasm of tumor cells with or without glycogen. Mitotic visible. Cancer tissues but not to the differentiation of squamous epithelium and glandular structures.
electron microscopy: the cytoplasm of cancer cells seen a lot of rough endoplasmic reticulum and ribosomes. Visible tension wires (squamous differentiation), or micro-tube formation (adenoid differentiation.) Cytoplasm of cancer cells in some cases see a large number of glycogen particles.
immunohistochemistry: antibody cancer cells of epithelial markers such as cytokeratin, epithelial membrane antigen (EMA) were positive, etc., but vimentin (vimentin) markers and neuroendocrine markers were negative.
variant of large cell carcinoma – differential diagnosis of clear cell carcinoma
a. metastatic clear cell carcinoma: If the kidney, thyroid, parotid gland and other parts of the clear cell carcinoma metastasis to the lung, the lung morphology is very similar to clear cell carcinoma. Clinical examination and immunohistochemistry, can be identified.
b. clear cell tumors (clear cell tumor) or sugar tumor (sugar tumor): the lung tissue origin of the more common of the benign yet clear. With clear cell carcinoma of the difference is between the former blood vessel rich, mainly capillaries and sinusoids. Reticular fiber staining tumor cells around a single fiber network distribution. PAS staining, indicating that the cytoplasm of tumor cells may contain glycogen. Immunohistochemical markers of tumor cells of epithelial markers were negative, but vimentin, NSE "HMB45, Leu-7 and the 5-100 protein is marked as positive.
Prognosis: The prognosis of clear cell carcinoma of the lung and large cell carcinoma similar.