Large cell neuroendocrine carcinomas (LCNEC) have large cells with moderate to abundant quantity of pink cytoplasm. The nuclei have vesicular chromatin and prominent nucleoli – an important point of distinction from small cell carcinoma. Mitotic activity is increased (usually > 30 mitoses/2 sq.mm). Some cases of LCNEC show well-defined areas of squamous cell carcinoma, adenocarcinoma, spindle cell carcinoma, or giant cell carcinoma. Such cases are classified as combined LCNEC and the components clearly identified in the pathology report.