Large cell carcinoma of the lung

It is a heterogeneous group of undifferentiated malignant neoplasms that lack the cytologic and architectural features of small cell carcinoma and glandular or squamous differentiation.

Make up about 5% of lung cancers.

These lesions show no evidence of squamous or glandular differentiation, and do not  have histologic features suggestive of neuroendocrine differentiation with neuronal markers.

A type of NSCLC (non-small-cell lung carcinoma) which originates from epithelial cells of the lung. 

LCLC is histologically characterized by the presence of large, undifferentiated cells that lack distinctive features of either squamous cell carcinoma or adenocarcinoma or other types of cancers.

LCLC tumor cells are abundant pale staining cytoplasm and prominent nucleoli. 

Can appear in any part of the lung, but usually peripherally.

Often associated with tissue necrosis.

Appear on histological examination as sheets of relatively large malignant cells that lack the features of small cell carcinomas.

Cells lack squamous, glandular or papillary characteristics.

Presentation of LCLC is nonspecific and can include symptoms such as: 

Persistent Cough

Shortness of breathe/pain with breathing

Chest pain

Unintentional weight loss

General fatigue


Frequent upper respiratory infections 

Difficulty swallowing


The diagnosis of exclusion: tumor cells lack light microscopic characteristics that would classify the neoplasm as a small-cell carcinoma, squamous-cell carcinoma, adenocarcinoma, or other more specific histologic type of lung cancer.

Several variants of LCC, include:

large cell neuroendocrine carcinoma

basaloid carcinoma

lymphoepithelioma-like carcinoma

clear cell carcinoma

large cell carcinoma with rhabdoid phenotype.

Large-cell neuroendocrine carcinoma (LCNEC)

In most series, LCLC’s comprise between 3%-9% of all primary lung cancers.

Risk of large cell lung carcinoma increases with a previous history of tobacco smoking, with a previous smoking duration of 30 to 40 years giving a relative risk of approximately 2.3 compared to never-smokers, and a duration of more than 40 years giving a relative risk of approximately 3.6.

Treatment often requires a multidisciplinary approach.

Treatment options:


Chemotherapy: Often use of platinum-based agents with other cytotoxic drugs are used to target the tumor.

Targeted Therapy: A type of treatment that targets specific features of the cell to minimize damaging healthy cells and to reduce side effects of the treatment.

Immunotherapy: A form of treatment that boosts the body’s natural immune defense system to apprehend the cancer cells. 

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