Histological Type

Crucial therapeutic distinction is made between small cell carcinoma and non-small cell (squamous/adenocarcinoma/large cell) carcinoma.

Squamous cell carcinoma

— 40-50% of cases. Requires nuclear stratification, intercellular bridges, ±keratinization.

— keratinizing/non-keratinizing.


— spindle cell (see carcinosarcoma): cytokeratin positive ± vimentin positive.

— basaloid: poor prognosis, nests of palisaded basaloid cells with central comedonecrosis, hyalinised stroma.

— papillary: >70% exophytic or papillary malignant epithelial fronds with focal invasion at the base and better prognosis (70% 5-year survival).

— adenoidsquamous: usual prognosis, acantholytic (pseudoglandular) pattern.

— adenosquamous: mixed differentiation with the minor component at least 10% of the tumour. Worse prognosis. Adenocarcinoma may have obvious glands or is solid with mucin positive cells.

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