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Large-cell carcinoma of the lung with a remarkable preoperative
elevation of serum carcinoembryonic antigen level.Gen
Thorac Cardiovasc Surg. 2007 May;55(5):217-21
Carcinoembryonic
antigen, a serum tumor marker, is useful for diagnosing cancer and for
following the response to therapy in cancer cases. Serum
carcinoembryonic antigen levels are also important as a predictive
tool in evaluating prognosis. A 56-year-old man presented with an
abnormal shadow on a chest X-ray. His preoperative serum
carcinoembryonic antigen was at an elevated level of 1274.0 ng/ml.
Chest computed tomography revealed a tumor in the posterior segment of
the right lung and a swollen right interlobar lymph node. Right lung
pneumonectomy and node dissection were performed. A histological
diagnosis determined that the tumor was a large-cell carcinoma at
clinical stage IIA. Immunohistochemical analysis detected the
production of carcinoembryonic antigen by the tumor cells. Following
surgery, the patient's carcinoembryonic antigen levels were maintained
within the normal range. This is a rare case of lung cancer with no
evidence of recurrence and metastasis for 8 years despite markedly
elevated preoperative carcinoembryonic antigen levels.
A case of
large cell carcinoma of the lung with rhabdoid phenotype.
Nihon Kokyuki Gakkai Zasshi. 2006 Apr;44(4):325-9.
A 37-year-old man
was admitted to our hospital because of suspicion of the lung cancer
in November 2003. Transbronchial tumor biopsy revealed a small number
of tumor cells with rhabdoid features, which had eosinophilic
cytoplasmic globules. However, a definitive histological diagnosis was
not obtained. We considered that a diagnosis of lung malignant tumor
was likely according to the findings of chest CT scan and pathology.
Although radiotherapy reduced the tumor size, he started to have
abdominal pain and tarry stool one month after radio therapy. Multiple
small intestine metastases were detected by gastroenterological
endoscopy. The patient died due to bleeding from these metastatic
lesions in May 2004. Immunohistologic staining of the cervical lymph
node showed that rhabdoid cells were positive for epithelial membrane
antigen (EMA), vimentin, and anticytokeratin antibody (CAM5.2), but
not for thyroid transcription factor-1 (TTF-1). From the autopsy
findings and clinical course, he was finally diagnosed with large cell
carcinoma of the lung with rhabdoid phenotype. Because of its
aggressive clinical course, early diagnosis and decision on therapy
would be very important for this disease.
Pulmonary large cell
carcinoma with rhabdoid phenotype.Ann
Diagn Pathol. 2005 Aug;9(4):223-6.
Large cell
carcinoma of the lung with a rhabdoid phenotype is very rare. We
present a 55-year-old man with multiple nodules in his lung. He had an
emergency operation because of abundant hemoptysis. The microscopic
appearance was a large cell carcinoma with a pure rhabdoid phenotype.
There were no foci of any other carcinomatous components. Tumor cells
had abundant eosinophilic cytoplasmic globules and eccentric nuclei
and did not adhere to each other. Histochemically, these cells were
periodic acid-Schiff-negative. Immunohistochemically, vimentin and
neuron-specific enolase were positive. Epithelial membrane antigen was
focally and weakly positive, p53 was positive in 60% of tumoral cells,
and Ki-67 (MIB-1 labeling index) was 50%. The patient died of
disseminated disease 2 months after the operation.
Pulmonary large cell
carcinoma with rhabdoid phenotype.Ultrastruct
Pathol. 2003 Jan-Feb;27(1):55-9.
A 70-year-old
woman presented with a coin lesion in her left lung. The tumor was
well circumscribed and had a large area of central necrosis with a
thin rim of viable tumor cells. It showed a solid growth pattern of
polygonal cells with eosinophilic intracytoplasmic inclusion bodies.
Immunohistochemically, the tumor cells were positive for vimentin,
neural cell adhesion molecule, neuron-specific enolase, and vascular
endothelial growth factor. Electron microscopy revealed
intracytoplasmic inclusion bodies consisting of whorled intermediate
filaments. Based on histological and immunohistochemical findings, the
patient was diagnosed as having pulmonary large cell carcinoma with
rhabdoid phenotype (LCCRP). The patient was in stage IA, and the
histological findings may be the prototype of pure LCCRP. The tumor
recurred after 6 years, and the second tumor had more apparent
intracytoplasmic inclusion bodies. It is worthwhile detecting and
recognizing the significance of these intracytoplasmic inclusions
because of the poor prognosis of this tumor.
Large cell carcinoma
of the lung with a rhabdoid phenotype.Pathol
Int. 2002 Oct;52(10):643-7.
A variant of
large cell carcinoma showing a rhabdoid phenotype, which is rare among
primary lung cancers, is presented. A 59-year-old man was admitted to
hospital for an operation. Computed tomography scans showed a mass
with a smooth border, invading the thoracic wall. A right upper lobe
lobectomy was carried out with resection of a part of the thoracic
wall. Pathological examination showed that the tumor was mostly
composed of cells with prominent eosinophilic cytoplasmic globules and
giant cells, which did not adhere to each other. Cytologically, the
tumor cells contained nuclei with a reticular chromatin pattern and
one to two prominent nucleoli, and hyaline-like and reticular
inclusion bodies, which were immunohistochemically positive for
vimentin, but not for alpha-smooth muscle actin, myoglobin or pan-actin.
Radiological and laboratory examinations did not detect the presence
of the tumor in other organs, indicating that the primary lesion was
not situated elsewhere. Metastasis to the right adrenal gland was
observed 1 year and 4 months after the operation; however, the patient
has been free of the disease 3 years and 11 months after the second
operation of an adrenalectomy. This case showed a relatively good
prognosis, which is rare among rhabdoid tumors of various organs that
generally have poor prognoses with rapid, fatal progression.
Large cell
carcinoma of the lung with neuroendocrine differentiation. A
comparison with large cell "undifferentiated" pulmonary tumors.
Am J Clin Pathol.
1992 Jun;97(6):796-805.
Twelve large cell
carcinomas of the lung showing evidence of neuroendocrine
differentiation (LCCND) were compared with 15 other large cell
pulmonary tumors that lacked such features (NELCUC). All lesions were
composed of partially necrotic, nested, or sheet-like arrays of
mitotically active, nucleolated large cells that were at least twice
the size of those seen in small cell carcinomas. Examples of LCCND
were defined by immunoreactivity for neuron-specific enolase, Leu-7,
synaptophysin, and chromogranin-A, and by their content of
neurosecretory granules on electron microscopy. NELCUCs were devoid of
these immunohistologic and ultrastructural features. There were six
women and six men with LCCND, who ranged in age from 38 to 82 years.
Of nine individuals in this group with Stage T1NOMO or T2NOMO disease
at diagnosis, five (55%) died of their neoplasms within 3 years of
diagnosis; three more (33%) have recurrent or persistent tumors and
are likely to die as a result. On the other hand, 47% of patients with
NELCUC of similar stages are free of disease after a similar follow-up
period. LCCND is a distinctive clinicopathologic disease and should
not be classified with unspecified large cell anaplastic carcinomas of
the lung. Its behavior is potentially aggressive and may justify
consideration of a specialized treatment protocol. Because electron
microscopic evaluation of immunohistologic features must be done to
recognize LCCND, it is probably underdiagnosed.
Large cell
carcinoma of the lung. Ultrastructural and immuno- histochemical
features.Chest. 1986
Oct;90(4):524-7.
Forty one
cases of large cell anaplastic carcinoma of the lung (LCACL) were
investigated by electron microscopy and immunoperoxidase studies for
cytokeratin, enolase, and carcinoembryonic antigen. The results
indicated that these neoplasias, grouped as an unique entity by
ordinary histopathologic findings, may be further divided into five
groups as follows: squamous, adenomatous, adenosquamous,
neuroendocrine, and undifferentiated. The authors suggest that this
subclassification may be useful in treatment orientation and in the
prognostic evaluation of these neoplasias.
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