OVERVIEW OF SMALL CELL LUNG CANCER IN MALAYSIA

Afiqa Nadhira A.R, Nor Izzati B., Siti Sarah A.,Wan Nurhafizah W.M,, Siti Mahfuzah Z., Hamizah Z., Noor Hafizah M.Z.
Bachelor of Medical Laboratory Technology, Department of Medical Laboratory Technology, Faculty of Health Sciences, University Technology Mara,
Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor.

1 . 0 INTRODUCTION 4 . 0 DIAGNOSIS OF SCLC 5.0 MICROSCOPIC VIEW OF SCLC

1.1 Definition
4.1 Sample collection and preparation 5.1 Cytological diagnostic features
-Lung cancer is a disease in which malignant cells are form in § Cluster of small malignant
the lung tissue. ØSputum Cytology - Screening test cells- loosely arranged. (1)
-It divided into 2 forms:   (Kennedy, Miller, & Prindiville, 2000)
§High N/C ratio 2
1) Small cell lung cancer (SCLC): The aggressive (fast-growing) - Suitable for early detection
- Centrally located tumors §Prominent nuclear molding § Hyperchromatic nuclei. (2)
cancer develop from the cells of neural origin form in the lung 1
tissue which can spread to other body part. Also known as oat (Rivera, Detterbeck, & Mehta, 2003)
§Finely granular nuclear chromatin (salt and pepper chromatin) § Scanty cytoplasm.
cell cancer. - Analyze the sputum each morning for
2) Non-small cell lung cancer (NSCLC): Group of lung cancer three days. §Scanty cytoplasm.
which made up from different kind of cells. It can be - Fixative solution: 2% carbowaxand § Finely granular chromatin.
subdivided into 3 main types which are; i) Squamous cell 50% alcohol.
carcinoma, ii) Large cell carcinoma and iii) Adenocarcinoma. (Byers, et al., 2008) (Kulawik, Gornicka, Krenke, Mich, & Chazan, 2010)
ØBronchoscopic - Bronchiol brushing
(National Cancer Institute, 2009) Specimens - Bronchiol washing Figure 4: Sputum smear
1.2 Statistic Case in Malaysia on 2006 (Varghese, Venkataraman, & Bhagwat, 2005)
-Lung cancer is the third most common cancer among ØPleural Fluid - Fine needle aspiration of a §Nuclear moulding. (1)
populations in Peninsular Malaysia. supraclavicular node or metastatic .
-There were 2,048 cases of lung cancer registered with1,445 of site. 1, 3 2 §Scanty cytoplasm. (2)
males (71%) and 603 of females (29%). (Rivera, Detterbeck, & Mehta, 2003) § A salt and pepper look
-It is the second most common cancer among males in to the chromatin.
Peninsular Malaysia. §Cells with high
§ Scanty cytoplasm.
-The incident are increase with age (more than 50 years old). N/C ratio. (3)
§
Figure 1: Lung Age Specific Cancer by Gender, Peninsular Malaysia 2006
Figure 3: Bronchoscopy technique
Bronchoscopy is a procedure
used to look inside the lung
airways. Figure 5: Pleural fluid smear Figure 6: Sputum smear
A bronchoscope is inserted
- through the mouth, trachea, 1
and bronchus into the lung. § Small clusters of
Lymph nodes are shown along benign
-Chinese have higher incidence rate compared to Malay and trachea and bronchi, and mesothelial cells. (1) §High nuclear/cytoplasmic
Indians. cancer in one lung. ratio.
-
§ Three larger cells from §Scant, delicate, and basophilic
Figure 2: Incidents of Lung Cancer over all cancers according to ethnicity.
small cell lung cancer cytoplasm.
on the edge of one of § Nuclear molding.
4.2 Preservation prior to processing the clusters. (2) § Finely granular “salt and
Races/Gender Male (%) Female (%) ØRecord appearance : Color and volume. pepper” chromatin.
ØDirect smear method : - 2 adhesive coated slides fix in § Salt and pepper § Cells are tightly clustered.
Malay 13.7 3.8 2, 3
Chinese Cancer Registry,
16.1 6.4 of Health Malaysia, 2006) 95% ethanol. chromatin.(3)
(National Ministry - 2 plain slides for dried smear (Brahm, et al., ND)
Indian 8.3 3.3
(at least 30 minutes). Figure 7: Pleural fluid smear Figure 8: Bronchiol brushing smear
ØStorage : 4°C and discard after 1 week
(Non Gynae Preparation Techniques, ND) 6 . 0 REFERENCES
JOURNALS:
2.0 CAUSES OF SCLC 
National Cancer Registry, Ministry of Health Malaysia. (2006). Malaysian Cancer Statistic: Data and Figure Peninsular Malaysia 2006. 9.
4.3 Staining of the smears 
Michael, B. A., Stephen, S. G., Gene, C. L., & Robin, R. M. (2003). Initial Evaluation of the Patient With Lung Cancer*: Symptoms, Signs,
ØSmears fixed with alcohol 
M., R. P., Frank, D., & Atul, M. C. (2003). Diagnosis of Lung Cancer*: The Guideline. CHEST , 131-133.
2.1 - Tobacco smoking -Papanicolou stain 
Byers, T., Wolf, H. J., Franklin, W. A., Braudrick, S., Merrick, D. T., Shroyer, K. R., et al. (2008). Sputum Cytologic Atypia Predicts Incident
- Biggest risk factor for lung cancer. -To demonstrate nuclear details and giving cytoplasmic Lung Cancer:Defining Latency and Histologic Specificity. Cancer Epidemiology,Biomarkers & Prevention , 158-162.
transparency. 
Kennedy, C. T., Miller, Y., & Prindiville, S. (2000). Screening for Lung Cancer Revisited and the Role of Sputum Cytology and Fluorescence
2.2 - Environmental factor
ØAir dried smears Bronchoscopy in a High-Risk Group*. Chest , 72S-79S.
- Exposure to substances (asbestos, radon, radiation).
-May-Grunwald Giemsa stain 
Varghese, D. C., Venkataraman, D. K., & Bhagwat, D. S. (2005). Manual for Cytology. India: Directorate General of Health Services,
2.3 - Age and genetic -To demonstrate cytoplasmic detail and extracellular Ministry of Health and Family Welfare, Government of India.
- Increases with age substance. 
Non Gynae Preparation Techniques. Selangor: Department of Pathology Hosptal Tengku Ampuan Rahimah, Klang.
- Family -To demonstrate cell and nuclear size
3 . 0 background with lungOF
SYMPTOMS cancer.
SCLC
(Health Information Publications, 2004) (Non Gynae Preparation Techniques, ND)

Laboratory Tests, and Paraneoplastic Syndromes. CHEST , 98.
 

Kulawik, J. D., Gornicka, B., Krenke, R., Mich, S., & Chazan, R. (2010). The value of cytological diagnosis of small cell lung carcinoma.
3.1 - Cough   Via Medica, 203-210
- Most common symptom -
WEBSITES:
3.2 - Cough up blood 
Health Information Publications. (2004). What Causes Lung Cancer. Retrieved September 10, 2010, from eHealthMD:
3.3 - Chest pain
3.4 - Shortness of breath http://www.ehealthmd.com/library/lungcancer/LCN_causes.html
3.5 - Difficulty swallowing 
Brahm, C., Byerly, T., Callahan, S., Eighme, K., Guggolz, R., Ludlow, E., et al. (n.d.). Non-Gyn Atlas. Retrieved september 20, 2010, from
3.6 - Swelling of face and hands Cytology Stuff: http://www.cytologystuff.com/indexnongyn.htm
(Michael, Stephen, Gene, & Robin, 2003) 
National Cancer Insitute. (2009, August). General Information About Small Cell Lung Cancer. Retrieved September 29, 2010, from
http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/Patient/page1
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