large cell neuroendocrine carcinoma of the lung
Large cell neuroendocrine carcinoma (LCNEC) of the lung is classified as a subtype of large cell carcinoma of the lung. It is also classified as a pulmonary neuroendocrine tumor.
Epidemiology
The incidence peaks around the 6decade . There is an increased male predilection . They are rare and may accounts for ∼3% of all lung cancers, although the proportion of lung cancers diagnosed as large cell neuroendocrine carcinoma may be increasing .
Pathology
Large cell neuroendocrine carcinoma of the lung is poorly differentiated and high-grade neuroendocrine tumors .
They have neuroendocrine morphology, neuroendocrine differentiation on immunohistochemistry, often high mitotic rates (>10 mitoses/mm) and non-small cell cytological features .
As with other neuroendocrine cells of the lung, large cell neuroendocrine carcinoma arises from Kulchitsky cells of the bronchial mucosa .
Associations
There is a strong association with smoking .
Radiographic features
CT
CT features are non-specific. Large cell neuroendocrine carcinomas, in general, tend to present as oval-to-round and well-demarcated masses with lobulated margins. Their size typically ranges from 2 to 5 cm. Internal calcification is uncommon (9-21%) . A slight peripheral predilection may be present . There can be homogeneous or inhomogeneous enhancement following contrast .
Treatment and prognosis
They tend to be aggressive high-grade tumors with a poor prognosis . The overall prognosis is thought to be between that of an atypical pulmonary carcinoid and small cell lung cancer .
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Assoziationen und Differentialdiagnosen zu large cell neuroendocrine carcinoma of the lung:
