Abnormal squamous cell lung cancer

By | March 31, 2012

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.

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