Chemotherapy with Cisplatin and VP-16 was begun. No asbestos bodies were found in iron-stained sections of lung away from the tumor, and the unilateral pleural plaque was attributed to collapse therapy for his tuberculosis. A group of tumors that shows neuroendocrine differentiation occurs in the lung. These tumors are defined by their growth pattern and cytologic features, by the presence of neurosecretory granules ultrastructurally, and by the presence of a number of neuropeptides that can be detected biochemically or by immunohistochemical methods. The individual tumors, although all potentially malignant, vary greatly in their clinical behavior from the low grade carcinoid tumor to the rapidly fatal small cell carcinoma.
Classification systems attempt to predict behavior on the basis of morphology.
Even when a central mass is present, lobar collapse is uncommon because the tumor tends not to obstruct the bronchus. Both tissue and cytologic specimens are useful in diagnosing the disease. Once a histologic diagnosis of SCC of the lung is made, the extent of tumor spread is determined. If no metastatic sites outside the thorax are found, limited disease should be staged by the TNM system used for nonsmall cell carcinoma in order to diagnose the small number of patients who may benefit from surgical resection. In contrast to central carcinoid tumors that form polypoid masses in the bronchial lumen, small cell cancers often invade the wall directly, producing only a slight irregularity of the surface mucosa and no luminal stenosis, although obstructive tumors do occur.