Large cell carcinoma of the lung differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Large cell carcinoma of the lung must be differentiated from other diseases that cause non-productive cough, weight loss, fatigue, and dyspnea among adults such as tuberculosis, pulmonary fungal disease, lung abscess, and more importantly from other causes of non-small cell lung cancers, such as adenocarcinoma and squamous cell lung cancer.

Differential Diagnosis

• The table below summarizes the findings that differentiate large cell carcinoma of the lung, from other diseases that cause non-productive cough, weight loss, fatigue, and dyspnea among adults such as tuberculosis, pulmonary fungal disease, lung abscess, and more importantly other causes of non-small cell lung cancers, such as adenocarcinoma and squamous cell lung cancer.

Differential Diagnosis	Similar Features	Differentiating Features
Pulmonary tuberculosis	Cough, weight loss, fatigue, and dyspnea	In pulmonary tuberculosis, differentiating features include: size increase despite optimal medical therapy, patients age is usually younger, hemoptysis is an early feature, and CXR anatomical predilection for upper lobes
Lung abscess	Non-productive cough, weight loss, and chest pain	In lung abscess, differentiating features include: acute or sub-acute onset, CXR anatomical predilection for upper lobes, and usually resolve with antibiotic
Pneumonia	Cough, weight loss, fatigue, and dyspnea	In pneumonia, differentiating features include: good response to antibiotics, acute onset, predilection on CXR is consolidation, laboratory markers indicate infection
Pulmonary fungal infection	Non-productive cough, weight loss, fatigue, and dyspnea	In pulmonary fungal infection, differentiating features include: CXR findings: air-cresecent sign, no response to antibioitcs, and mimics tuberculosis
Other non-small cell lung cancers	Non-productive cough, weight loss, fatigue, and dyspnea	In other non-small cell lung cancers , differentiating features include: histopathologica features, such as larger size of the anaplastic cells, a higher cytoplasmic-to-nuclear size ratio, and a lack of "salt-and-pepper" chromatin

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