Non-Small Cell Lung Cancer Professional Information

CELLULAR CLASSIFICATION

Prior to initiating treatment of any patient with lung cancer, a review of pathologic material by an experienced lung cancer pathologist is critical since some cases of small cell lung cancer (which responds well to chemotherapy) can be confused on microscopic examination with non-small cell carcinoma.[1] Nonsquamous cell cancers may be more likely to recur after surgical resection of early stage I tumors than other types of non-small cell lung cancers.[2] Bronchoalveolar carcinoma represents 10% to 25% of adenocarcinomas and sometimes has a distinct presentation and biologic behavior.[3-5] Bronchoalveolar cancer may present as a more diffuse lesion than other types of cancer; 30% to 40% of patients undergoing an attempt at surgical resection present with an infiltrate on their chest radiograph. Bronchoalveolar cancer is more common in women and in patients who do not smoke cigarettes than other histologic types of lung cancer.

Histologic classification of non-small cell lung cancer:

• squamous cell (epidermoid) carcinoma
  • spindle cell variant
• adenocarcinoma
  • acinar
  • papillary
  • bronchoalveolar [4,5]
  • solid tumor with mucin
• large cell carcinoma
  • giant cell
  • clear cell
• adenosquamous carcinoma
• undifferentiated carcinoma

1. Kreyberg L, Liebow AA, Uehlinger EA: International Histologic Classification of Tumours: No. 1. Histological Typing of Lung Tumours. Geneva: World Health Organization, 2nd ed., 1981.
2. Thomas P, Rubinstein L: Cancer recurrence after resection: T1 N0 non-small cell lung cancer: Lung Cancer Study Group. Annals of Thoracic Surgery 49(2): 242-246, 1990.
3. Harpole DH, Bigelow C, Young WG, et al.: Alveolar cell carcinoma of the lung: a retrospective analysis of 205 patients. Annals of Thoracic Surgery 46: 502-507, 1988.
4. Grover FL, Piantadosi S: Recurrence and survival following resection of bronchioloalveolar carcinoma of the lung: the Lung Cancer Study Group experience. Annals of Surgery 209(6): 779-790, 1989.
5. Daly RC, Trastek VF, Pairolero PC, et al.: Bronchoalveolar carcinoma: factors affecting survival. Annals of Thoracic Surgery 51(3): 368-377, 1991.

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