Changes in Morphologic and Biochemical Characteristics of Small Cell Carcinoma of the Lung A Clinicopathologic Study

Our plain-English summary of Changes in Morphologic and Biochemical Characteristics of Small Cell Carcinoma of the Lung A Clinicopathologic Study, by M.D. Abeloff, J.C. Eggleston, G. Mendelsohn, et al (1979).

The study

• Authors: M.D. Abeloff, J.C. Eggleston, G. Mendelsohn, D.S. Ettinger, S.B. Baylin
• Published: The American Journal of Medicine, Volume 66. May 1979.
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This reviewed Johns Hopkins Hospital autopsy records for 40 patients with biopsy-proved small cell carcinoma of the lung, seen 1970 to 1978. The article does not mention asbestos. At autopsy, 5 of the 40 had no small cell carcinoma, only squamous carcinoma (three), adenocarcinoma (one) or large cell undifferentiated carcinoma (one). Six more had other cancer patterns alongside small cell carcinoma. The remaining 29 had only small cell carcinoma. Four of the five had first been diagnosed as the intermediate cell type, and all five had relatively localized disease at diagnosis. In four of these, the authors measured the enzymes histaminase and L-dopa decarboxylase. Levels were markedly lower than an earlier study in the same laboratory had found in small cell carcinoma, though values overlapped. The authors said the cause could not be firmly determined. They concluded that doctors should consider that a tumor may contain several cell types, and suggested larger biopsy samples before treatment when possible. They added that these five patients' disease seemed to progress more slowly than usual, but that the small number of patients and retrospective design precluded definite conclusions.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: retrospective clinicopathologic review of autopsy cases, with laboratory enzyme measurements on autopsy tumor tissue
• Who was studied: 40 autopsy patients with biopsy-proved small cell carcinoma of the lung seen at The Johns Hopkins Hospital, Baltimore, between 1970 and 1978
• Main results:
  • In 5 of the 40 patients, only non-small cell carcinoma was seen at autopsy: squamous carcinoma in three, adenocarcinoma in one, large cell undifferentiated carcinoma in one
  • In 6 of the 40 patients, other lung cancer patterns were present in addition to small cell carcinoma at autopsy
  • In the other 29 of the 40 patients, small cell carcinoma was the only tumor at autopsy
  • The five patients with only non-small cell carcinoma at autopsy had presented with relatively localized disease, of intermediate cell type in four of the five
  • The course of tumor progression in these five patients appeared more indolent than the typical case of small cell carcinoma
  • In four of the cases with no small cell carcinoma at autopsy, histaminase and L-dopa decarboxylase levels in the lung tumor and mediastinal metastases were markedly lower than levels found in small cell carcinoma in a previous study, although the values overlapped
• The authors' conclusion: The authors concluded that the mechanism could not be firmly determined. They said it is important to consider that a tumor may contain more than one cell type when evaluating a newly diagnosed patient, since other types of lung cancer appeared in 11 of 40 autopsy cases (28 per cent). They suggested obtaining larger biopsy samples before treatment whenever possible.
• Limitations the authors state:
  • The small number of patients and the retrospective nature of the study preclude any definite conclusions about the observed features of the five patients, such as their apparently more indolent course
  • Adequate tissue was not available to measure the enzymes in the original biopsy specimens of the patients later found to have non-small cell carcinoma at autopsy

Topics

Medical terms in this study, explained in our Lexicon: Small Cell Lung Cancer, Autopsy, Biopsy, Carcinoma, Adenocarcinoma.

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