Large-Cell Carcinoma Of The Lung

What Is It?

Large-cell carcinoma is a type of non-small-cell lung cancer that represents 10 percent to 20 percent of all tumors that originate in the bronchi, which are the main branches of the windpipe (trachea) that lead to the lungs. This type of lung cancer is associated strongly with smoking.

Large-cell tumors are usually large at the time of diagnosis. They tend to be accompanied by extensive bleeding and tissue damage. They often are referred to as undifferentiated tumors because the cells lack the specific architecture found in other types of cancer cells. Large-cell carcinoma tends to grow quickly and spread (metastasize) at an earlier stage than other forms of non-small-cell lung cancer.

The constant flow of fluids through the lungs can carry cancer cells to adjoining structures, such as the chest wall or the diaphragm. These fluids consist of blood and lymph (a protein-filled fluid). Unless large-cell carcinoma is diagnosed and treated early, it can spread to organs outside of the chest area.

Symptoms

Although some cancers initially have no symptoms, others can cause any of the following:

• A persistent cough
• Coughing up blood (hemoptysis)
• Shortness of breath or wheezing
• Fatigue
• Recurrent pneumonias in the same place
• Unexplained weight loss or loss of appetite
• Difficulty swallowing
• Pain in the chest, shoulder or arm
• Bone pain
• Hoarseness
• Headaches or seizures
• Swelling of the face, neck or upper extremities
• Enlargement of the ends of fingers and toes (digital clubbing), in particular the skin around the fingernails

Diagnosis

Large-cell carcinoma often is discovered on a chest X-ray, on which it appears as a gray or whitish area. Other imaging studies, such as computed tomography (CT) or magnetic resonance imaging (MRI) scans, can be used to further determine the size, shape and location of the tumor. This helps to find the best place to obtain a sample of the tumor to differentiate large cell carcinoma from other types of lung cancer such as small-cell carcinoma or adenocarcinoma of the lung. The type of cancer affects the type of treatment you should get.

Another way to diagnose the tumor type is with sputum cytology, in which mucus from the lungs (sputum) is examined under a microscope to check for abnormal cells. However, this technique is most effective when the cancer is centrally located. It isn't as accurate for detecting small, peripheral tumors. Cancer cells also can be found in fluid between the lung and the chest wall (requiring a thoracentesis procedure using a needle to remove pleural fluid) or in lymph nodes next to the lung (requiring a mediastinoscopy surgical procedure).