Adenocarcinoma of the lung diagnostic study of choice: Difference between revisions
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*** FNA may also be obtained during bronchoscopy, along with endobronchial ultrasound, to take samples of lymph nodes around the trachea and bronchi. | *** FNA may also be obtained during bronchoscopy, along with endobronchial ultrasound, to take samples of lymph nodes around the trachea and bronchi. | ||
:* [[Thoracentesis]] | :* [[Thoracentesis]] | ||
:** Thoracentesis may be done to remove fluid from around the lungs to see if it contains cancer cells. | :** Thoracentesis may be done to remove fluid from around the lungs to see if it contains cancer cells. | ||
:* | :* On microscopic histopathological analysis, nuclear atypia, eccentrically placed [[Cell nucleus|nuclei]], abundant [[cytoplasm]], and conspicuous [[Nucleolus|nucleoli]] are characteristic findings of adenocarcinoma of the lung. | ||
:* Atypical adenomatous hyperplasia (AAH): is the precursor of peripheral adenocarcinomas. It consists of well demarcated [[Columnar epithelia|columnar]] or [[Cuboidal epithelia|cuboidal]] cells with the following features:<ref>{{cite book | last = Kumar | first = Vinay | title = Robbins basic pathology | publisher = Saunders/Elsevier | location = Philadelphia, PA | year = 2007 | isbn = 1416029737 }}</ref><ref>{{cite book | last = Stewart | first = Bernard | title = World cancer report 2014 | publisher = International Agency for Research on Cancer,Distributed by WHO Press, World Health Organization | location = Lyon, France Geneva, Switzerland | year = 2014 | isbn = 9283204298 }}</ref> | |||
:** Varying degrees of cytologic [[atypia]] | |||
:** Hyperchromasia | |||
:** [[Pleomorphism]] | |||
:** Prominent [[nucleoli]] | |||
:* As adenocarcinoma is a derivative of [[mucus]] producing glands in the lungs, it tends to stain [[mucin]] positive. | |||
:* Based on differentiation, the [[tumor]] may be: | |||
:** Well differentiated (low grade): Normal appearance | |||
:** Poorly differentiated (high grade): Abnormal [[Gland|glandular]] appearance with a positive mucin stain | |||
:* '''Subtypes'''<ref name="libre">Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/Adenocarcinoma_of_the_lung#Microscopic Accessed on December 20, 2015</ref> | |||
:**Lepidic predominant: | |||
:*:*[[Tumor]] grows long the [[Alveolus|alveolar]] wall | |||
:**[[Acinus|Acinar]] predominant: | |||
:*:*Berry-shaped glands, smaller than lung [[Acinus|acini]] | |||
:**[[Papillary]] predominant: | |||
:*:*Fibrovascular cores | |||
:**Micropapillary predominant: | |||
:*:*Nipple shaped projections without fibrovascular cores | |||
:**Solid predominant: | |||
:*:*Sheet of [[Cell (biology)|cells]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} |
Revision as of 21:55, 2 March 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Adenocarcinoma of the Lung Microchapters |
Differentiating Adenocarcinoma of the Lung from other Diseases |
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Diagnosis |
Treatment |
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Overview
Biopsy is the diagnostic study of choice for adenocarcinoma of the lung.
Diagnostic Study of Choice
- Biopsy is helpful in the diagnosis of adenocarcinoma of the lung.
- Fine needle aspiration (FNA)[1]:
- CT guided FNA uses a small amount of tissue from a suspected lung tumour or from a lymph node in the chest.
- FNA may also be obtained during bronchoscopy, along with endobronchial ultrasound, to take samples of lymph nodes around the trachea and bronchi.
- Fine needle aspiration (FNA)[1]:
- Thoracentesis
- Thoracentesis may be done to remove fluid from around the lungs to see if it contains cancer cells.
- On microscopic histopathological analysis, nuclear atypia, eccentrically placed nuclei, abundant cytoplasm, and conspicuous nucleoli are characteristic findings of adenocarcinoma of the lung.
- Atypical adenomatous hyperplasia (AAH): is the precursor of peripheral adenocarcinomas. It consists of well demarcated columnar or cuboidal cells with the following features:[2][3]
- Varying degrees of cytologic atypia
- Hyperchromasia
- Pleomorphism
- Prominent nucleoli
- As adenocarcinoma is a derivative of mucus producing glands in the lungs, it tends to stain mucin positive.
- Based on differentiation, the tumor may be:
- Well differentiated (low grade): Normal appearance
- Poorly differentiated (high grade): Abnormal glandular appearance with a positive mucin stain
- Subtypes[4]
- Lepidic predominant:
- Acinar predominant:
- Berry-shaped glands, smaller than lung acini
- Papillary predominant:
- Fibrovascular cores
- Micropapillary predominant:
- Nipple shaped projections without fibrovascular cores
- Solid predominant:
- Sheet of cells
- Thoracentesis
References
- ↑ Lung cancer. Canadian Cancer Society 2015.http://www.cancer.ca/en/cancer-information/cancer-type/lung/diagnosis/?region=ab#Endoscopy
- ↑ Kumar, Vinay (2007). Robbins basic pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 1416029737.
- ↑ Stewart, Bernard (2014). World cancer report 2014. Lyon, France Geneva, Switzerland: International Agency for Research on Cancer,Distributed by WHO Press, World Health Organization. ISBN 9283204298.
- ↑ Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/Adenocarcinoma_of_the_lung#Microscopic Accessed on December 20, 2015