Well, optically, no it's not so different from enlarging to paper. But the things is, if you make an interpositive and then a copy neg using ortho film, then you have dueling contrast ranges. You might need to develop the interpositive with a developer of one contrast and then develop the copy neg with another... so there are coupled variables to tune and that's what makes it inherently trickier than a straight enlargement to paper.
About LVTs, I know that Chicago Albumen does them to 16x20, but "only" at 1016 ppi.