You Make the Diagnosis: A 62 Year Old Female with Hemoptysis and Fatigue

A 62-year-old female presents with hemoptysis and fatigue. A large mass is found adjacent to the right main bronchus. A representative field is shown here. What is the diagnosis?


  1. Invasive adenocarcinoma
  2. Squamous cell carcinoma
  3. Adenocarcinoma in situ (formerly bronchoalveolar carcinoma)
  4. Small cell carcinoma
  5. Large cell carcinoma



The diagnosis in this case is small cell carcinoma. Also called “oat cells,” the malignant cells in this tumor tend to be round to somewhat elongated in shape, with the typical “salt-and-pepper” chromatin of neuroendocrine tumor cells. The cells are often so closely apposed that their nuclear contours show a characteristic “molding” effect. Small cell carcinoma is a fast growing tumor (note the large mitotic figure at 4 o’clock) with a poor prognosis.



-Kristine Krafts, MD, is an Assistant Professor of Pathology at the University of Minnesota School of Medicine and School of Dentistry and the founder of the educational website Pathology Student.



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