carcinoma

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A carcinoma is any malignant cancer that arises from epithelial cells. Carcinomas invade surrounding tissues and organs and may metastasize, or spread, to lymph nodes and other sites.

Carcinoma in situ (CIS) is a pre-malignant condition, in which some cytological signs of malignancy are present, but there is no histological evidence of invasion through the epithelial basement membrane.

Classification

Carcinoma, like all neoplasia, is classified by its histopathological appearance. Adenocarcinoma and squamous cell carcinoma, two common descriptive terms for tumors, reflect the fact that these cells may have glandular or squamous cell appearances respectively. Severely anaplastic tumors might be so undifferentiated that they do not have a distinct histological appearance (undifferentiated carcinoma).

Sometimes a tumor is referred to by the presumptive organ of the primary (eg carcinoma of the prostate) or the putative cell of origin (hepatocellular carcinoma, renal cell carcinoma).

Metastatic carcinoma can be diagnosed through biopsy, including fine-needle aspiration, core biopsy, or subtotal removal of single node.^[1]

Types by ICD-O (International Classification of Diseases - Oncology) Code

(8010-8790) Epithelial

• (8010-8040) Epithelial neoplasms, NOS
• (8050-8080) Squamous cell neoplasms
  • (M8070/3) Squamous cell carcinoma, NOS
• (8090-8110) Basal cell neoplasms
  • (M8090/3) Basal cell carcinoma, NOS
• (8120-8130) Transitional cell papillomas and carcinomas
• (8140-8380) Adenomas and Adenocarcinomas (glands)
  • (M8140/0) Adenoma, NOS
  • (M8140/3) Adenocarcinoma, NOS
  • (M8142/3) Linitis plastica
  • (M8151/0) Insulinoma, NOS
  • (M8152/0) Glucagonoma, NOS
  • (M8153/1) Gastrinoma, NOS
  • (M8155/3) Vipoma
  • (M8160/3) Cholangiocarcinoma
  • (M8170/3) Hepatocellular carcinoma, NOS
  • (M8200/3) Adenoid cystic carcinoma
  • (M8240/1) Carcinoid tumor, NOS, of appendix
  • (M8271/0) Prolactinoma
  • (M8290/0) Oncocytoma
  • (M8290/0) Hurthle cell adenoma
  • (M8312/3) Renal cell carcinoma
  • (M8312/3) Grawitz tumor
  • (M8360/1) Multiple endocrine adenomas
  • (M8380/0) Endometrioid adenoma, NOS
• (8390-8420) Adnexal and Skin appendage Neoplasms
• (8430-8439) Mucoepidermoid Neoplasms
• (8440-8490) Cystic, Mucinous and Serous Neoplasms
  • (M8440/0) Cystadenoma, NOS
  • (M8480/6) Pseudomyxoma peritonei
• (8500-8540) Ductal, Lobular and Medullary Neoplasms
• (8550-8559) Acinar cell neoplasms
• (8560-8580) Complex epithelial neoplasms
  • (M8561/0) Warthin's tumor
  • (M8580/0) Thymoma, NOS
• (8590-8670) Specialized gonadal neoplasms
  • (M8590/1) Sex cord-stromal tumor
  • (M8600/0) Thecoma, NOS
  • (M8620/1) Granulosa cell tumor, NOS
  • (M8630/1) Arrhenoblastoma, NOS
  • (M8631/0) Sertoli-Leydig cell tumor
• (8680-8710) Paragangliomas and Glomus tumors
  • (M8680/1) Paraganglioma, NOS
  • (M8700/0) Pheochromocytoma, NOS
  • (M8711/0) Glomus tumor
• (8720-8790) Nevi and Melanomas
  • (M8720/0) Melanocytic nevus
  • (M8720/3) Malignant melanoma, NOS
  • (M8720/3) Melanoma, NOS
  • (M8721/3) Nodular melanoma
  • (M8727/0) Dysplastic nevus
  • (M8742/3) Lentigo maligna melanoma
  • (M8743/3) Superficial spreading melanoma
  • (M8744/3) Acral lentiginous melanoma, malignant

Types of lung carcinoma

• Adenocarcinoma is a malignant tumor originating in the epithelial cells of glandular tissue and forming glandular structures. This is common in the lung (forming 30-40% of all lung carcinomas). It is found peripherally, arising from goblet cells or type II pneumocytes.

• Squamous cell carcinoma due to squamous metaplasia. This accounts for 20-30 percent of lung tumors and is usually hilar in origin.

• Small cell carcinoma is almost certainly due to smoking. These metastasise early, and may secrete ADH (lowering patient sodium concentration).

• Large cell undifferentiated carcinomas account for 10-15 percent of lung neoplasms. These are aggressive and difficult to recognise due to the undifferentiated nature. These are most commonly central in the lung.

Staging and grading

The staging of cancers is the extent of spread of the neoplasm. Grading is the system used to record the tumors degree of differentiation from the parent tissue. High grade lesions shows little differentiation and may convey a worse prognosis depending on tumor type. As a general rule, cancer stage (using AJCC criteria) dictates ultimate prognosis. The criteria for staging differ based on organ system. For example, the colon and bladder cancer staging system relies on depth of invasion. Breast and lung staging is more dependent on size. While renal carcinoma staging is based on both size and invasion into the renal sinus. Accurate staging is reliant on clinical, radiographic, and pathologic data. The UICC/AJCC TNM system is often used, however for some common tumors, classic staging methods (such as the Dukes classification for colon cancer) are still used.

See also

• Cancer
• Sarcoma
• Hematological malignancy
• Basal cell carcinoma

References