Small Cell Carcinoma

General description

Small cell carcinoma accounts for 20% of all lung cancers.

It is of neuroendocrine origin and is highly aggressive,
metastasizing early. Smoking association is well demonstrated
(only 1% of cases in non-smokers). Incurable via surgery.

Incidence
20% of all lung cancers.
Symptoms

• See adenocarcinoma of lung for symptoms common to all lung

cancers.
• Symptoms usually present for less than 3 months prior to
diagnosis (aggressive).
• Possible paraneoplastic syndromes, i.e. tumor cells may
produce ACTH, resulting in Cushing's syndrome or ADH
resulting in in inappropriate anti-diuretic hormone syndrome.
 Pathophysiology

• All lung cancers begin as small focus of thickening/piling up of

bronchial mucosa.
• 90% of small cell carcinomas begin in central airways
(consistent with smoking association).
• Cells of neuoroendocrine origin (hence possible production of
hormones).
• Small cell staged as limited or extensive (spread outside
chest); 70% are extensive.
Histopathology

• Cells look like lymphocytes except that nuclei are 2x the size.
• Abundance of small cells.
• Cells look dark (hyperchromatic) with scanty cytoplasm.