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2015; Masai et al. There was no significant association between any pathologic variable and death outcome. Histologic subclassification in a manner identical to nonmucinous tumors may provide valuable prognostic information. The definition of STATS, while accepted in the current WHO Classification, is not consensual. {Diaz, 1999 #45}. AB, FT an AP conceived of the study, and participated in its design and coordination and helped to draft the manuscript. J Thorac Oncol 10:1156–1162, Strand TE, Rostad H, Strom EH, Hasleton P (2015) The percentage of lepidic growth is an independent prognostic factor in invasive adenocarcinoma of the lung. Adenocarcinoma; Lung; Model; Prognosis; Tumor grading. The subtype is denoted based on the predominant histologic pattern observed. Mucinous adenocarcinomas of the lung have been subclassified and defined in various ways. Privacy There was no association between other pathologic parameters and distant metastasis (p > 0.1). (Zhao et al. (Xu et al. The most common tumors among this group are mucoepidermoid carcinoma and adenoid cystic carcinoma. The current diagnostic criteria for hepatoid adenocarcinoma of lung include typical acinar or papillary adenocarcinoma and a component resembling hepatocellular carcinoma and expressing α-fetoprotein (AFP). The largest diameter of the tumor was divided into < 2, 2–5, and > 5 cm size categories. In contrast to areas of lepidic growth where the elastic framework of the lung is intact, acinar adenocarcinoma has stromal invasion, as evidenced by disruption of the elastic framework with bundles of broken elastic fibers seen on VVG stains accompanied by desmoplastic tumor stroma 10 … Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. not applicable. A total of 30 cases were included, representing 9% of all resections of pulmonary adenocarcinomas from 2003 to 2014. published one of the most comprehensive studies on mucinous tumors of the lung and found only TNM stage and loss of P16 expression to impact survival. Cai D, Li H, Wang R, Li Y, Pan Y, Hu H, Zhang Y, Gong R, Pan B, Sun Y, Chen H (2014) Comparison of clinical features, molecular alterations, and prognosis in morphological subgroups of lung invasive mucinous adenocarcinoma. Am J Clin Pathol 139:160–166, Xu L, Tavora F, Burke A (2013) Histologic features associated with metastatic potential in invasive adenocarcinomas of the lung. It is defined by the presence of “abundant” intracytoplasmic mucin and has a predilection for multicentricity, large areas of in-situ growth, and by KRAS(Kirsten rat sarcoma viral oncogene) mutations. A grading system for pulmonary adenocarcinoma has not been established. Hung JJ, Yeh YC, Jeng WJ, Wu KJ, Huang BS, Wu YC, Chou TY, Hsu WH. Distant metastasi bns developed in 7 patients (4 brain, 1 soft tissue, 1 adrenal, one vertebra and liver). 2015). Local recurrence developed in 7 patients, determined by open surgical biopsy in 6, and imaging in 1. (Geles et al. Censors were set for two times points with statistics run independently: time to distant recurrence; and time to lung recurrence. More recently, 2 additional SGT, namely hyalinizing clear cell carcinoma and salivary duct-like carcinoma were recognized as primary lung tumors expanding the … The proportions of tumors with solid cribriform, papillary, micropapillary and acinar subtypes are presented in Table 2. (Rossi et al. According to the new classification proposed by an international multidisci… We and our partners process personal data such as IP Address, Unique ID, browsing data for: Use precise geolocation data | Actively scan device characteristics for identification.. Definition / general | Case reports | Treatment | Microscopic (histologic) description. Qu Y, Zhao D, Mu J, Che N, Zhang C, Liu Z, Su D, Zhou L, Zhang H, Wei L (2015) Prognostic analysis of primary mucin-producing adenocarcinoma of the lung: a comprehensive retrospective study. 2013; Kamata et al. An autopsy study by Thunissen et al. As no standardized definition for mucinous adenocarcinoma of the lung has been established, “mucinous” was defined in this study as a mucin-producing adenocarcinoma (presence of airspace mucin pools) with intracellular mucin in at least 50% of the tumor cells. This study was approved by the Institutional Review Board of the University of Maryland Medical Center. Weng CF, Huang CJ, Huang SH, Wu MH, Tseng AH, Sung YC, Lee HH, Ling TY. The growth patterns of mucinous adenocarcinomas should be reported like reporting of non-mucinous adenocarcinomas. Bethesda, MD 20894, Copyright Mucinous adenocarcinomas of the lung account for approximately 10–15% of lung adenocarcinomas and have been reported to portend a poorer prognosis than non-mucinous adenocarcinoma (Cai et al. volume 1, Article number: 3 (2018) Clusters within 0.5 mm of the tumor edge was graded as type 1 STAS, whereas clusters beyond 0.5 mm of the tumor edge and present in ≥2 low magnification (2.5 mm diameter) fields were designated as grade 2. Invasive adenocarcinoma of lung, acinar type. Clipboard, Search History, and several other advanced features are temporarily unavailable. FOIA https://doi.org/10.1007/s13277-015-3869-1. The relative prevalence of the neoplasm in the various salivary gland reflects the abundance of acinic cells: parotid gland (~80%) > minor salivary glands (~17%) > submandibular glands (~3%). (Tsuta et al. Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger K, Yatabe Y, Powell CA, Beer D, Riely G, Garg K, Austin JH, Rusch VW, Hirsch FR, Jett J, Yang PC, Gould M; American Thoracic Society. Adenocarcinoma is the most common (primary lung cancer). The model consists of the following: grade 1, lepidic predominant tumor; grade 2, acinar or papillary predominant tumor, both with no or less than 20% of high-grade patterns; and grade 3, any tumor with 20% or more of high-grade patterns (solid, micropapillary, or complex gland). https://doi.org/10.1186/s42047-018-0013-8, DOI: https://doi.org/10.1186/s42047-018-0013-8. Surgical and Experimental Pathology Similar to published reports, we found STAS to be associated with poorer prognosis, but only in the sense of local recurrence. Given these findings, we suggest that mucinous adenocarcinomas be subclassified and graded in the same manner as their non-mucinous counterparts: with specific note to percentage of solid growth, micropapillary architecture, STAS, and size of invasive component. Tumor spread through alveolar spaces (“STAS”, alternately “aerogenous metastases” or “small cluster invasion”) has been linked to poorer clinical outcomes, including higher rates of lymphatic involvement and lymph node metastases (Kawakami et al. Carcinoma … PathologyOutlines.com website. Pathology and Genetics of Tumors of the lung, Pleura, Thymus and heart. Lung cancer is the leading cause of cancer-related death in developed countries. 561. post-template-default,single,single-post,postid-561,single-format-standard,qode-quick-links-1.0,ajax_fade,page_not_loaded,,qode_grid_1300,footer_responsive_adv,qode-content-sidebar-responsive,qode-child-theme-ver-1.0.0,qode-theme-ver-12.0.1,qode-theme-bridge,wpb-js-composer js-comp-ver-5.4.2,vc_responsive. J Pathol 209:78–87, Warth A, Muley T, Meister M, Stenzinger A, Thomas M, Schirmacher P, Schnabel PA, Budczies J, Hoffmann H, Weichert W (2012) The novel histologic International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification system of lung adenocarcinoma is a stage-independent predictor of survival. Receiver operating characteristic curve analysis was used to select the best model, which was validated (n = 212) and tested (n = 300, including stage I-III) in independent cohorts. {Thunnissen, 2016 #43} An older study on breast tissue describes tissue displacement in breast tissue and in a high percentage of cases. Tumors with 0 or < 20% solid or solid cribriform growth were considered group 1; tumors with 20% or more solid or solid cribriform growth were considered group 2. Am J Surg Pathol 28:442–452, Russell PA, Wainer Z, Wright GM, Daniels M, Conron M, Williams RA (2011) Does lung adenocarcinoma subtype predict patient survival? Acinar-predominant adenocarcinoma of the lung Dr Daniel J Bell ◉ and Dr Yuranga Weerakkody ◉ et al. Recently, STAS has been included as a type of invasion in the 2015 WHO classification of lung tumors. Nonpredominant lepidic pattern correlates with better outcome in invasive lung adenocarcinoma. Metastasis was determined by imaging in 5 patients, biopsy in 1 patient, and cerebrospinal fluid cytology in one patient. Article  Previous published reports have shown STAS to be an indicator of poor prognosis. Shopping. Qu et al. Acinar Adenocarcinoma Acinar adenocarcinoma is a common type of adenocarcinoma with tumor cells ar-ranged in classic glandular structure on a fibroelastic stroma. (Travis et al. Similar results were seen in the validation (AUC = 0.732 for RFS and 0.787 for OS) and test cohorts (AUC = 0.690 for RFS and 0.743 for OS), confirming the predictive value of the model. Springer Nature. 4). The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 2015; Russell et al. focused on “large” islands that were at least “several alveoli” separated from the edge of the tumor. In addition, several distinct patterns of growth have been reported, including mucinous, papillary, micropapillary, hepatoid, and signet-ring cell among others.2–13However, primary oncocytic adenocarcinomas of the lung have not … Non-small cell lung cancers (NSCLC) comprise 75% of all lung cancers and consist of three major histologic types: squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. (Fig. c. Cuboidal cells with eosinophilic cytoplasm. Tumor size included the entire lesion, invasive and non-invasive were recorded used a conventional ocular micrometer. (Onozato et al. adenocarcinoma lung pathology outlines. J Thorac Oncol 10:1444–1450, Zhao RY, Zhang J, Zhu L, Shao JC, Zhang Q, Teng HH, Qin G, Zhao LX, Ye M, Zhao JK, Ding WJ (2016) Expression of ALK protein in 7 371 pulmonary adenocarcinoma samples, with analysis of clinicopathologic features. J Thorac Oncol 6:1496–1504, Shim HS, Kenudson M, Zheng Z, Liebers M, Cha YJ, Hoang Ho Q, Onozato M, Phi Le L, Heist RS, Iafrate AJ (2015) Unique genetic and survival characteristics of invasive mucinous adenocarcinoma of the lung. Methods: 2012) are important parameters in the mucinous subset as well. 2015) Jessurun et al. The WHO classification currently views invasive mucinous adenocarcinoma as a “variant” and therefore not subject to pattern subclassification. Time-adjusted Kaplan Meier curves relating STAS to local recurrence (top) and proportion of solid growth to distant recurrence (bottom). 2015) In fact, these entities were not represented in the current study despite several cases showing entirely lepidic architecture, either because of size criterion (> 3 cm) or presence of STAS. Pathologic parameters predicting poor outcome have not been extensively studied, including the presence of spread through alveolar spaces (STAS). Copyright © 2020 International Association for the Study of Lung Cancer. J Clin Oncol 30:1438–1446, Watanabe M, Yokose T, Tetsukan W, Imai K, Tsuboi M, Ito H, Ishikawa Y, Yamada K, Nakayama H, Fujino S (2013) Micropapillary components in a lung adenocarcinoma predict stump recurrence 8 years after resection: a case report. Tumors were classified according to predominant mucin-producing cell type, where mucin production was confirmed with PAS and mucicarmine stains. Cancers (Basel). By using this website, you agree to our Results: Cite this page: Pernick N. Acinar (pending). Fabio Tavora. The major changes in the 2015 WHO classification of adenocarcinomas of the lung (resected tumors) are: 1) Discontinuing the terms bronchioloalveolar carcinoma and mixed subtype adenocarcinoma; 2) Adding Adenocarcinoma-in-situ to the list of pre-invasive lesions; 3) Introducing the concept of minimally-invasive adenocarcinoma; 4) Classification of invasive adenocarcinomas … Google Scholar. Tumour Biol 37(1):887–96. 1a-d ). Mucinous adenocarcinomas of the lung are similar to non-mucinous prognostically, in that STAS and solid growth are poor prognosticators, for local and distant recurrence, respectively. Prevention and treatment information (HHS). PubMed Central  Although 5 cases showed either entirely lepidic architecture or less than 0.5 cm of invasion, these cases were all classified as invasive mucinous adenocarcinoma due to the size (n = 3) or due to the presence of STAS (n = 2). … Invasive mucinous adenocarcinoma of the lung is a subtype of invasive adenocarcinoma of the lung formerly known as mucinous bronchoalveolar carcinoma (BAC).They are more likely to be multicentric and tend to have a worse prognosis than non-mucinous types. 2013) Onozato et al. In the 2015 WHO classification of lung tumors, minimally-invasive adenocarcinoma of the lung is defined as a small solitary adenocarcinoma measuring less than or equal to 3 cm with an invasive component less than or equal to 0.5 cm in greatest dimension. The 2015 World Health Organization (WHO) lung adenocarcinoma classification divides tumours into categories of indolent pre-invasive, minimally invasive and predominantly lepidic and, by examining predominant patterns of invasion, allows for further stratification into intermediate and high-grade tumours. There was a significant increase in the rate of local recurrence by STAS (p = .005) and in the rate of distant recurrence by solid invasive group (p = .003). The medical term “acinar adenocarcinoma” is derived from both Latin and Greek languages: the word “acinar” originates from a Latin word acinus that means “berry,” while “adenocarcinoma” is a combination of the words adeno and carcinoma, both of which mean “gland” and “cancer,” respectively. Distinguishing hepatoid adenocarcinoma of lung from hepatocellular carcinoma metastatic to lu … Current readings: pathology, prognosis, and lung cancer. Tumor size ranged from 0.6 to 8.2 cm. Privacy, Help The International Association for the Study of Lung Cancer pathology panel evaluated a set of histologic criteria associated with prognosis aimed at establishing a grading system for invasive pulmonary adenocarcinoma. demonstrated that large size and presence of invasion were associated with a bad outcome. It is a common form of cancer occurring in the lung and prostate gland. FT and AB participated in the design of the study and performed the statistical analysis. Similar results were seen in the validation (AUC = 0.732 for RFS and 0.787 for OS) and test cohorts (AUC = 0.690 for RFS and … We retrospectively studied time to lung recurrence and time to distant metastasis in 30 mucinous lung tumors, in relationship to histologic parameters, including spread through alveolar spaces, tumor size, invasive size, % invasive size, growth pattern (solid or cribriform, acinar, papillary, micropapillary, and lepidic), type of mucin-producing cell, and TTF-1 positivity. Air travels from our mouth and nose down the airways into the lungs. Pathology. Accessibility (Geles et al. Copy link. 2009), and higher rates of recurrence (Onozato et al. All tumors were treated and diagnosed in a single institution and were discussed in multi-disciplinary conference, with radiological and clinical evaluation and assumption of a lung primary tumor. Introduction: (Rossi et al. (Kadota et al. Mucinous adenocarcinoma is often considered a relatively poor prognostic group among adenocarcinomas of the lung and has a high rate of pulmonary recurrence. Righi L, Vatrano S, Di Nicolantonio F, Massa F, Rossi G, Cavazza A, Volante M, Votta A, Izzo S, Lo Iacono M, Ardissone F, Di Maio M, Novello S, Scagliotti GV, Papotti M (2016) Retrospective multicenter study investigating the role of targeted next-generation sequencing of selected Cancer genes in mucinous adenocarcinoma of the lung. Onco Targets Ther 7:2127–2132, PubMed  2006; Wu et al. The objective of our study is to correlate histologic features, including presence and type of STAS, architectural growth patterns, percent of invasiveness, mucin cell type, and TTF1 reactivity, with clinical outcome in a series of mucinous adenocarcinomas. There was a significant association between STAS and lung recurrence (Fig. 2011 Sep;8(5):381-5. doi: 10.1513/pats.201107-042ST. statement and The novel histologic International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification system of lung adenocarcinoma is a stage-independent predictor of survival. It is of Zhonghua Bing Li Xue Za Zhi 45:601–605, CAS  2016; Watanabe et al. 2013) In general, absent TTF1 reactivity is associated with a more advanced clinical stage and a larger tumor size, if mucinous and nonmucinous tumors are studied together. PubMed Google Scholar. a. Columnar cells with cytoplasmic clearing. Mucinous adenocarcinomas are generally recognized to show a low rate of reactivity for TTF1, as goblet cells are negative for TTF-1 in contrast to pneumocytes and Clara cells. 2016) A mucinous variant of micropapillary carcinoma has also been described, which corresponds to mucinous carcinomas in the current study with micropapillary STAS. Mucinous adenocarcinoma is often considered a relatively poor prognostic group among adenocarcinomas of the lung and has a high rate of pulmonary recurrence. 2014) A recent study including both small biopsies and surgical resections has found that ALK fusion protein is more frequently seen in invasive mucinous adenocarcinomas than in other adenocarcinomas. This proposal has not yet been tested in clinical datasets to determine whether it defines prognostically significant subgroups of lung adenocarcinoma. Acinar adenocarcinoma is the cause of roughly 90% of prostate cancer cases. Am J Surg Pathol 37:1100–1108, Zhang Y, Wang R, Li Y, Pan Y, Hu H, Zhang Y, Li H, Shen L, Yu Y, Sun Y, Chen H (2015) Negative thyroid transcription factor 1 expression defines an unfavorable subgroup of lung adenocarcinomas. STAS of any type was present in 22 (73%) of cases. https://doi.org/10.1007/s13277-015-3869-1, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s42047-018-0013-8. (Kamata et al. 2015 Dec;90(3):568-74. doi: 10.1016/j.lungcan.2015.10.014. Some glands appear as solid clusters of tumor cells and lack a recognizable lumen. 3Department of Pathology, Hachioji Medical Center of Tokyo Medical University, Japan Abstract Background and objective: The 4th edition of the WHO Classification of Tumors of the Lung, Pleura, Thymus and Heart states that adenocarcinomas should be classified according to the predominant pattern. (Shim et al. There was a significant association between distant metastasis and solid invasive growth (Fig. University of Maryland Medical Center, 22 S. Greene St., Baltimore, MD, 21201, USA, Messejana Heart and Lung Hospital, Rua Frei Cirilo, 3460, Fortaleza, CE, 60160150, Brazil, You can also search for this author in Cookies policy. Adenocarcinoma in situ, either serous or mucinous . A higher proportion (11/16 or 69%) of cuboidal predominant tumors showed some TTF1 positivity; of these, 9 cases (82%) showed diffuse staining and 2 (18%) showed focal reactivity (p < 0.01). Lung adenocarcinoma is primarily categorized on the basis of histopathologic evaluation, although testing for genetic mutations (e.g. We retrospectively studied time to lung recurrence and time to distant … Acinar Adenocarcinoma of Lung is a histological subtype of pulmonary adenocarcinoma. The histopathology of lung cancer appears to be changing: The incidence of squamous cell carcinoma in the United States is declining, accompanied by the increase in the incidence of adenocarcinoma. The growth patterns of mucinous adenocarcinomas should be reported similar to reporting of non-mucinous adenocarcinomas. Watch later. Diagn Pathol 10:94, Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin JH, Beasley MB, Chirieac LR, Dacic S, Duhig E, Flieder DB, Geisinger K, Hirsch FR, Ishikawa Y, Kerr KM, Noguchi M, Pelosi G, Powell CA, Tsao MS, Wistuba I, Panel WHO (2015) The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification.

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