Small cell carcinoma

— 25% of cases. Small round/fusiform nuclei (x2-3 lymphocyte size) with granular chromatin, moulding and an inconspicuous nucleolus, DNA crush and vessel artefact (Azzopardi effect), fir tree hyaline stroma, apoptosis, necrosis and mitoses. The nuclear features are the diagnostic characteristic of small cell carcinoma. Note that there can be a scattered population of large bizarre (polyploid) cells.

— intermediate: larger nucleus/more cytoplasm and most likely represents better preserved/fixed oat cell, i.e. the same tumour.

— combined: + non-small cell component, e.g. squamous or adenocarcinoma.

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