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5 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Large cell neuroendocrine carcinoma is a lung cancer that looks like a large-cell tumour under the microscope but has the neuroendocrine markers and the fast, aggressive behaviour of small-cell lung cancer. It sits between the two halves of the usual split, which is why teams disagree about whether to treat it as one or the other.
What it is. The fifth edition of the World Health Organization classification of thoracic tumours (2021) places large cell neuroendocrine carcinoma in the lung neuroendocrine neoplasm chapter, alongside typical carcinoid, atypical carcinoid and small cell carcinoma, rather than among the non-small-cell types it resembles by size and architecture (Nicholson 2022). The diagnosis needs both a neuroendocrine morphology, organoid nesting, rosettes or a trabecular pattern with a high mitotic count and necrosis, and confirmation of neuroendocrine differentiation by immunohistochemistry, which is why it is rarely diagnosed confidently on a small biopsy.
Where it sits in the family. It belongs to neither side of the clinical split that organises every other page in this family. The IASLC's ninth-edition staging work analysed pulmonary neuroendocrine carcinoma as its own group within the lung database, and clinical practice has run it both ways, as a non-small-cell cancer eligible for resection and adjuvant chemotherapy and as a small-cell cancer given platinum and etoposide. On this site it is a child of the lung cancer family page rather than of non-small-cell or small-cell lung cancer; the reasoning is set out in the taxonomy section of docs/CANCER-PAGES.md.
| Setting | Approach | Guideline |
|---|---|---|
| Localised disease | Resection where the tumour is resectable, staged by TNM 9 as for any other lung cancer, with adjuvant chemotherapy decided case by case; no randomised trial establishes the regimen, and teams differ over whether to use the small-cell or the non-small-cell backbone. | not mapped |
| Advanced disease | A platinum doublet, with the choice between the small-cell and the non-small-cell backbone made case by case; the parent and the small-cell page carry the regimens. | not mapped |