Small cell carcinoma of the lung diagnostic study of choice

Jump to navigation Jump to search

Small Cell Carcinoma of the Lung Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Small Cell Carcinoma of the Lung from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Radiation Therapy

Surgery

Prevention

Future or Investigational Therapies

Case Studies

Case #1

Small cell carcinoma of the lung diagnostic study of choice On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Small cell carcinoma of the lung diagnostic study of choice

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Small cell carcinoma of the lung diagnostic study of choice

CDC on Small cell carcinoma of the lung diagnostic study of choice

Small cell carcinoma of the lung diagnostic study of choice in the news

Blogs on Small cell carcinoma of the lung diagnostic study of choice

Directions to Hospitals Treating Small cell carcinoma of the lung

Risk calculators and risk factors for Small cell carcinoma of the lung diagnostic study of choice

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]Rim Halaby, M.D. [3]

Overview

The confirmation of the diagnosis of SCLC relies on the histopathological findings of the tumor biopsy. All patients with confirmed diagnosis of SCLC by histopathological findings should undergo a CT scan of the abdomen for staging purposes. CT scan of the abdomen helps identify metastasis to organs, such as the liver or the adrenal glands. Staging schemes for small cell lung cancer (SCLC) have been developed by the Veterans Administration Lung Study Group (VALG), the American Joint Committee on Cancer (AJCC), and the National Comprehensive Cancer Network (NCCN).

Diagnostic Study of Choice

Biopsy


Histopathologic image of small cell carcinoma of the lung. CT-guided core needle biopsy. H & E stain.By No machine-readable author provided. KGH assumed (based on copyright claims),via Wikimedia Commons [3]
Micrograph of a small-cell carcinoma of the lung showing cells with nuclear moulding, minimal amount of cytoplasm and stippled chromatin. FNA specimen. Field stain.By No machine-readable author provided. KGH assumed (based on copyright claims), via Wikimedia Commons [4]

CT

Chest CT scan, preferably with intravenous contrast administration, may be helpful in the diagnosis of small cell carcinoma. Findings on CT scan suggestive of small cell carcinoma include:[1]

Staging

The Veterans Administration Lung Study Group (VALG) staging, also known as VA staging, is an old staging system that has been previously used in most clinical trials. Shown below is a table depicting the VA staging system which classifies SCLC into two stages.[6]

Stage Characteristics
Limited SCLC
  • Limited SCLC is characterized by the strict involvement of the ipsilateral lung.
Extensive SCLC

AJCC and TNM Staging

Shown below is a table summarizing the staging of lung cancer according to the American Joint Committee on Cancer (AJCC). This staging scheme is the same for both SCLC and non small cell lung cancer.[7]

For more information about the TNM staging, click here.

Stage T N M
Occult carcinoma TX N0 M0
Stage 0 Tis N0 M0
Stage IA T1 N0 M0
Stage IB T2 N0 M0
Stage IIA T1 N1 M0
Stage IIB T2 N1 M0
T3 N0 M0
Stage IIIA T1, T2 N2 M0
T3 N1, N2 M0
Stage IIIB Any T N3 M0
T4 Any N M0
Stage IV Any T Any N M1

NCCN Staging

The National Comprehensive Cancer Network (NCCN) staging system combines the staging scheme of the AJCC and that of the VALG. Although the AJCC staging scheme is newer than that of the VALG, clinicians commonly use the VALG staging system because it has been commonly referred to in clinical trials. Shown below is a table depicting the NCNN staging which classifies SCLC into two stages.[1]

Stage Characteristics
Limited SCLC
  • Limited SCLC includes lung cancer cases of stage I, II, or III which can be treated with radiation therapy.
  • This stage does not include tumor T3 or T4 with multiple lung nodules, as well as tumor or lymph nodes that are too large to fit in the radiation plan.
Extensive SCLC
  • Extensive SCLC includes all SCLC categorized as stage IV, or
  • Tumor T3 or T4 with multiple lung nodules, or
  • Tumor or lymph nodes that are too large to fit in the radiation plan

References

  1. 1.0 1.1 1.2 NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014
  2. National Cancer Institute: PDQ® Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/healthprofessional.
  3. href="http://www.gnu.org/copyleft/fdl.html">GFDL</a> or <a href="http://creativecommons.org/licenses/by-sa/3.0/">CC-BY-SA-3.0</a>], <a href="https://commons.wikimedia.org/wiki/File%3ALung_small_cell_carcinoma_(1)_by_core_needle_biopsy.jpg">
  4. href="http://www.gnu.org/copyleft/fdl.html">GFDL ="http://creativecommons.org/licenses/by-sa/3.0/">CC-BY-SA-3.0], href="https://commons.wikimedia.org/wiki/File%3ALung_small_cell_carcinoma_(1)_by_core_needle_biopsy.jpg">
  5. href="https://commons.wikimedia.org/wiki/File:Carcinoma_microcellulare_oatcell_carcinoma_or_anaplastic_carcinoma_(lung)H%26E_magn_200x.jpg
  6. Micke P, Faldum A, Metz T, Beeh KM, Bittinger F, Hengstler JG; et al. (2002). "Staging small cell lung cancer: Veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer--what limits limited disease?". Lung Cancer. 37 (3): 271–6. PMID 12234695.
  7. Shepherd FA, Crowley J, Van Houtte P, Postmus PE, Carney D, Chansky K; et al. (2007). "The International Association for the Study of Lung Cancer lung cancer staging project: proposals regarding the clinical staging of small cell lung cancer in the forthcoming (seventh) edition of the tumor, node, metastasis classification for lung cancer". J Thorac Oncol. 2 (12): 1067–77. doi:10.1097/JTO.0b013e31815bdc0d. PMID 18090577.


Template:WikiDoc Sources