Lung Cancer / Pathology - Squamous cell carcinoma #usmle #neetpg #fmge #mbbs

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07/19/23

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Squamous cell carcinoma

Squamous cell carcinoma (SCC) is classically associated with a central location of origin (60-80%), arising most often from the segmented bronchi (where smoke is most concentrated when inhaled). However, SCC of the lung can also be seen in the periphery of the lung.

Squamous cell carcinoma (SCC) of the lung is the most common type of lung cancer in male smokers.

Smoking is the biggest risk factor for SCC of the lung.

Histologically, squamous cell carcinoma of the lung exhibits characteristics that are common to all squamous cell carcinomas in the body. Key cellular features include squamous keratin pearls, which stem from abundant keratinization by the malignant squamous cells and intercellular bridges (desmosomes).

Three genetic mutations are commonly seen in squamous cell carcinoma of the lung:
• p53
• p16 (aka 9p21)
• EGFR
Of all lung carcinoma types, squamous cell carcinoma shows the greatest frequency of p53 mutations. This is partly attributable to the large carcinogen load preceding the development of this cancer.

Marker of squamous cell carcinoma are cytokeratin, p40 and p63.

The gross appearance of squamous cell carcinoma of the lung is often a central cavitary mass due to extensive central necrosis.

Squamous cell carcinoma often appears as cavitating lesions on chest Xray.

It is most common Lung cancer associated with Pancoast tumor and Golden pneumonia (Lipoid pneumonia).

The most important factor affecting prognosis of patients with squamous cell carcinoma of the lung is the stage of presentation. The signs and symptoms of squamous cell carcinoma of the lung are often nonspecific.

In some cases of squamous cell carcinoma of the lung, production and secretion of PTHrP (parathyroid hormone related peptide) by neoplastic cells can cause hypercalcemia of malignancy. For this reason, some patients with SCC of the lung can present with signs and symptoms similar to those seen in hyperparathyroidism.

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