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Large Cell NE Carcinoma : Differential

slide 41 of 92

Comments:
Large Cell Neuroendocrine Carcinoma (LCNEC) vs Atypical Carcinoid: LCNEC has larger foci of necrosis (usually) and greater mitotic activity (> 10 mitoses/2 sq.mm; average of 75 mitoses/2 sq.mm) than atypical carcinoid.

LCNEC vs Small Cell Lung Carcinoma (SCLC): The distinction is made on H&E-stained slides. LCNEC has large cell size, more abundant pink cytoplasm, low nuclear-to-cytoplasmic ratio, vesicular, coarse, or clumped nuclear chromatin, and usually prominent nucleoli. SCLC has small cell size (less than 3 times the diameter of small resting lymphocytes), scant cytoplasm, finely granular chromatin, and inconspicuous/absent nucleoli.

LCNEC vs Adenocarcinoma, Basaloid Squamous Cell Carcinoma & Other Non-small Cell Carcinomas: Adenocarcinomas and basaloid squamous cell carcinoma of the lung generally lack neuroendocrine differentiation. Basaloid squamous cell carcinoma is positive for p40 and CK5/6 and negative for TTF-1. Other tumors that enter into the differential diagnosis of LCNEC include metastases from endometrium, ovary, pancreas, breast, prostate, and colon.

The image shows LCNEC under bronchial epithelium.

slide 41 of 92