Virchows Archiv A

, Volume 402, Issue 2, pp 147–153 | Cite as

Tumor heterogeneity in lung cancer based on light microscopic features

A retrospective study of a consecutive series of 200 patients, treated surgically
  • Fred R. Hirsch
  • Gyda Ottesen
  • Jan Pødenphant
  • Jens Olsen


In order to study the problem of morphological tumor heterogeneity in lung cancer, 200 consecutive patients who had undergone surgery for a malignant lung tumor, were evaluated retrospectively with regard to morphological type. The tumor was classified morphologically in 187 patients, and 163 (87%) had a morphologically homogeneous tumor, based on light microscopic features and using the criteria recommended by the World Health Organization. The remaining 24 patients (13%) had a tumor with morphologic features of more than one cell type.

It is concluded that morphological heterogeneity is a considerable problem in the classification of malignant lung tumors. This heterogeneity has been regarded as evidence of an endodermal origin of all major types of lung cancer. Future prospective studies will have to determine whether it has any therapeutic significance.

Key words

Lung cancer Tumor heterogeneity Histopathological classification 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abeloff MD, Eggleston JC, Mendelsohn G, Ettinger DS, Baylin SB (1979) Changes in morphologic and biochemical characteristics of small cell carcinoma of the lung. A clinicopathologic study. Am J Med 66:757–764Google Scholar
  2. Azzopardi JG (1959) Oat-cell carcinoma of the bronchus. J Pathol Bact 78:513–519Google Scholar
  3. Barnard WG (1926) The nature of the “oat-celled sarcoma” of the mediastinum. J Pathol Bact 29:241–244Google Scholar
  4. Churg A, Johnston WH, Stulbarg M (1980) Small cell squamous and mixed small cell squamous-small cell anaplastic carcinomas of the lung. Am J Surg Pathol 4:255–263Google Scholar
  5. Gazdar A.F, Carney DN, Guccion JG, Baylin SB (1981) Small cell carcinoma of the lung: Cellular origin and relationship to other pulmonary tumors. In: Greco FA, Oldham RK, Bunn PA (eds) Small cell lung cancer, Grune & Stratton, New York, pp 145–175Google Scholar
  6. Hansen HH, Rørth M (1982) Lung cancer. In: Pinedo HM (ed) Cancer chemotherapy 1982. The EORTC Cancer Chemotherapy Annual 4. Excerpta Medica, Amsterdam, pp 249–271Google Scholar
  7. Hashimoto T, Fukuoka M, Nagasawa S, Tamai S, Kusunoki Y, Kawahara M, Furuse K, Sawamura K, Fujimoto T (1979) Small cell carcinoma of the lung and its histological origin. Am J Surg Pathol 3:343–351Google Scholar
  8. Hirsch FR, Matthews MJ, Yesner R (1982) Histologic classification of small cell lung cancer. Cancer 50:1360–1366Google Scholar
  9. Hirsch FR, Østerlind K, Hansen HH The prognostic significance of histopathologic subtyping of small cell carcinoma of the lung according to the World Health Organization's classification. Cancer (in press)Google Scholar
  10. Kreyberg L (1967) Histological typing of lung tumours. International Histological Classification of Tumours, No. 1. World Health Organization, GenevaGoogle Scholar
  11. Matthews MJ (1979) Effect of therapy on the morphology and behavior of small cell carcinoma of the lung. A clinicopathologic study. In: Muggia F, Rosencweig M (eds) Lung cancer: Progress in Therapeutic Research. Raven Press, New Yorek, pp 155–165Google Scholar
  12. Matthews MJ, Gazdar AF (1981) Pathology of small cell carcinoma of the lung and its sub-types: a clinicopathologic correlation. In: Livingston RB (ed) Lung cancer. Martinus Nijhoff, Boston, pp 283–306Google Scholar
  13. McDowell EM, Trump BF (1981) Pulmonary small cell carcinoma showing tripartite differentiation in individual cells. Hum Pathol 12:343–351Google Scholar
  14. McDowell EM, McLaughlin JS, Merenyi DK, Kieffer RF, Harris CC, Trump BF (1978) The respiratory epithelium. V. Histogenesis of lung carcinomas in the human. J Natl Cancer Inst. 61:587–606Google Scholar
  15. Pearse AG (1969) The cytochemistry and ultrastructure of polypeptide hormone-producing cells of the APUD system and the embryologic, physiologic and pathologic implications of the concept. J Histochem Cytochem 17:303–313Google Scholar
  16. Vindeløv LL, Hansen HH, Christensen IJ, Spang-Thomsen M, Hirsch FR, Hansen M, Nissen NI (1980) Clonal heterogeneity of small cell anaplastic carcinoma of the lung demonstrated by flow-cytometric DNA analysis. Cancer Res 40:4295–4300Google Scholar
  17. World Health Organization (1981) Histological typing of lung tumours. International Histological Classification of Tumours. No 1 (2. ed), GenevaGoogle Scholar

Copyright information

© Springer-Verlag 1983

Authors and Affiliations

  • Fred R. Hirsch
    • 1
  • Gyda Ottesen
    • 1
  • Jan Pødenphant
    • 1
  • Jens Olsen
    • 1
  1. 1.Departments of Pathology, Finsen InstituteBispebjerg Hospital and Gentofte HospitalCopenhagenDenmark

Personalised recommendations