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Large cell carcinoma (LCC) is a “waste basket” histological group of non-small cell lung carcinomas (NSCLC). Prior to the 1999 World Health Organization (WHO) classification, these carcinomas were variously termed large cell anaplastic carcinoma or large cell undifferentiated carcinoma. In the current WHO classification, LCC is clearly defined as a malignant epithelial tumor composed of large cells lacking light microscopic or histochemical evidence of squamous, glandular or small cell differentiation. Nevertheless, this subgroup includes three distinctive histological entities, namely large cell neuroendocrine carcinoma (LCNEC), basaloid carcinoma and lymphoepithelioma-like carcinoma (LELC). In addition, two other morphological variants, namely clear cell and rhabdoid, warrant discussion (Table 1).
Large cell carcinomas are poorly differentiated tumors diagnosed in the absence of glandular or squamous features. This small group represents no more than 10% of lung cancers. However, if classified on the basis of either electron microscopy or molecular findings, this category would account for a far smaller percentage of lung carcinomas. LCNEC and basaloid carcinoma may be the most common LCC, with each accounting for 3 to 5% of lung carcinomas. Lymphoepithelioma-like carcinoma accounts for 1% of lung tumors in China, but even fewer in Western countries.
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