CASE N°13 – Small Cell Lung Carcinoma

Clinical History:

Age: 75

Sex: male

Chest pain & assiociated weight loss, smoker (20 cigarettes/die).  Chest radiography & computed tomography revealed cemtrally located lung mass about 3 cm in diameter with extensive necrosis. No other pathological findings. Bronchoscopy+biopsy was performed.

Cytological Images:

Cytological material: Trans-Bronchial FNAC

A) PAP 100x – High cellularity composed of viable and degenerating cells dispersed singly or in loose clusters.

B) PAP 200x – crush artifacts

C) PAP 200x – very scant cytoplasm, necrosis & finely granular chromatin pattern of the neoplastic cells.

D) PAP200x

E) PAP400x – nuclear molding

Cytological Report:

Positive for malignancy. Neoplastic cells with increased N/C ratio, scant cytoplasm, finely granular chromatin pattern, nuclear molding, crush artifact & necrosis are consistent with small cell lung carcinoma. 

Histological Images:

Histological material:  Trans-Bronchial FNAB

 H/E20x

 H/E 40x

 H/E100x

 Synaptofisin

Histological Report:

Neuroendocrine small cell lung carcinoma

Discussion:

Small cell lung carcinoma (SCLC) is the most aggressive form of lung cancer. It usually starts in the bronchi and grow very quickly  creating large tumors. Often spread rapidly (metastasize) to other parts of the body, including the brain, liver, and bone.
SCLC is highly sensitive to chemotherapy. Response rates vary between 50-90% depending on the stage of disease and the patient’s tolerance of the chemotherapy.

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