This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Respiratory system, Subject name: Anatomy
In a chronic smoker a highly malignant aggressive and metastatic lung carcinoma is 
Select and explain. 
A. Small cell carcinoma, B. Squamous cell carcinoma, C. Large cell carcinoma, D. Adenocarcinoma
A: Small cell carcinoma
Answer: A: Small cell carcinoma 
Explanation: Cigarette smoking is most strongly associated with squamous cell carcinoma and small cell carcinoma. Small cell carcinoma variant is more malignant and metasizes Ref Harrison 19th edition pg 1702