Mixed Lung Cancer in 46 Years Old, Male Smoker, Untreated Patient

Susilorini Susilorini*  -  Department of Pathology Anatomy, Faculty of Medicine, Sultan Agung Islamic University Semarang Corresponden Author, email : susilorinidr@gmail.com, Indonesia
Dik Puspasari  -  Department of Pathology Anatomy, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
Siti Amarwati  -  Department of Pathology Anatomy, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
Bambang Endro  -  Department of Pathology Anatomy, Faculty of Medicine, Diponegoro University, Semarang, Indonesia

(*) Corresponding Author

Lung cancer is a large heterogeneous family of malignancies, with tumors containing more than one subtype are very common. Over 50 different histologi­cal variants are recognized within the WHO typing system. Small Cell Lung Cancer comprises approximately 20% of all lung cancers and exhibits a neuroendocrine phenotype while Non Small Cell Lung Carsinoma (NSCLC) lacks these features and makes up the remaining 80% of cases. This case was reported in view of the rarity of this combination of morphologic patterns. The incidence of c- SCLC (Combined- Small Cell Lung Carsinoma) has been reported ranging from less than 1% to 14.6% of all SCLC. Mixed lung cancer in untreated patients suggests a common endodermal origin for c-SCLC which contains small-cell and non-small-cell pulmonary tumors. Quoix et al found that presentation as a solitary pulmonary nodule (SPN) is particularly indicative of a c-SCLC. Combined- Small Cell Lung Carsinoma contains a squamous cell and/or adenocarcinoma component. It’s becoming more important for pathologists to correctly subclassify NSCLC’s as distinct tumor entities, or as components of c-SCLC cause it’s more agrresive. A 46-year-old smoker man was referred because of rapid growth of a solitary nodule mass revealed by chest radiography with brain and limfonodes metastases. There was mixed histological feature including adenocarsinoma, squamous cell carsinoma and large cell carsinoma. The patient is dead after a few weeks later. It was revealed a panel immunohistochemistry stain (CK-7, CK-20, TTF-1, P63 and Chromoganin). It was concluded as c- SCLC.

Keywords : Mixed lung cancer; combined Small Cell Lung Carsinoma (c-SCLC); solitary nodul

  1. Aoyagi Y, Yokose T, Minami Y, et al. 2001.Accumulation of losses of heterozygosity and multistep carcinogenesis in pulmonary adenocarcinoma. Cancer Res.;61:7950–7954.
  2. Choe BP,et al. Differential disruption of cell cycle pathways in small cell and non-small cell lung cancer. British Journal of Cancer 2006; 94: 1927 – 1935.
  3. Kargi A, Gurel D, Tuna B. 2007.The diagnostic value of TTF-1, CK 5/6, and p63 immunostaining in classification of lung carcinomas. Appl Immunohistochem Mol Morphol. Dec;15(4):415-20.
  4. Masashi G, Yasumichi, Cheng-Long Huang, Hiroyasu Y. 2004. A combined small cell carcinoma of the lung containing three components: small cell, spindle cell and squamous cell carcinoma. Eur J Cardiothorac Surg;26:1047-1049.
  5. Patrick L, Wagner, Kitabayashi N,Yao-Tseng Chen, Saqi A. 2009.Combined Small Cell Lung Carcinomas Genotypic and Immunophenotypic Analysis of the Separate Morphologic Components. American Journal of Clinical Pathology;:131, 376-382.
  6. Quoix E, Fraser R, Wolkove N, Finkelstein H, kreisman H.1990. Small cell lung cancer presenting as solitary pulmonary nodule. Cancer J.66(3) 557-8.
  7. Radice PA, et al. 1982.The Clinical Behavior of “Mixed’ ’ Small Cell/Large Cell Bronchogenic Carcinoma Compared to “Pure” Small Cell Subtypes . Cancer 50:2894-2902.
  8. Roggli VL, Vollmer RT, Greenberg SD, McGavran MH, Spjut HJ, Yesner R. 1985. Lung cancer heterogeneity: a blinded and randomized study of 100 consecutive cases. Hum Pathol; 16: 569-79.
  9. Tatematsu A, Shimizu J, Murakami Y, Horio Y, Nakamura S, Hida T, Mitsudomi T, Yatabe Y. 2008. Epidermal growth factor receptor mutations in small cell lung cancer. Clin Cancer Res; 14: 6092-6.
  10. Travis, William D; Brambilla, Elisabeth; Muller-Hermelink, H Konrad et al., eds 2004. Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. World Health Organization Classification of Tumours. Lyon: IARC Press. ISBN 92 832 2418 3. http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/bb10-cover.pdf. Retrieved 27 March 2010.
  11. Zamecnik J, Kodet R. 2002.Value of thyroid transcription factor-1 and surfactant apoprotein A in the differential diagnosis of pulmonary carcinomas: a study of 109 cases. Virchows Arch ;440:353–361.
  12. Zhang H, Liu J, Cagle PT, et al. 2005. Distinction of pulmonary small cell carcinoma from poorly differentiated squamous cell carcinoma: an immunohistochemical approach. Mod Pathol.;18:111–118.

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Sains Medika : Jurnal Kedokteran dan Kesehatan
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ISSN: 2339-093X (Online) | 2085-1545 (Print)
DOI : 10.30659/sainsmed

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