Adenocarcinoma of the lung overview: Difference between revisions
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==Overview== | ==Overview== | ||
'''Adenocarcinoma of the [[lung]]''' ('''pulmonary adenocarcinoma''') is a common histological form of [[lung cancer]] that contains certain distinct malignant tissue architectural, cytological, or molecular features, including gland and/or duct formation and/or production of significant amounts of mucus.<ref name='who2004'>{{cite book |title=Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart |editor1-last=Travis |editor1-first=William D |editor2-last=Brambilla |editor2-first=Elisabeth |editor3-last=Müller-Hermelink |editor3-first=H Konrad |editor4-last=Harris |editor4-first=Curtis C |displayeditors=4|publisher=IARC Press |location=Lyon |year=2004 |series=World Health Organization Classification of Tumours |isbn=92-832-2418-3 |url=http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/bb10-cover.pdf |accessdate=27 March 2010}}</ref> | '''Adenocarcinoma of the [[lung]]''' ('''pulmonary adenocarcinoma''') is a common histological form of [[lung cancer]] that contains certain distinct malignant tissue architectural, cytological, or molecular features, including gland and/or duct formation and/or production of significant amounts of mucus.<ref name='who2004'>{{cite book |title=Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart |editor1-last=Travis |editor1-first=William D |editor2-last=Brambilla |editor2-first=Elisabeth |editor3-last=Müller-Hermelink |editor3-first=H Konrad |editor4-last=Harris |editor4-first=Curtis C |displayeditors=4|publisher=IARC Press |location=Lyon |year=2004 |series=World Health Organization Classification of Tumours |isbn=92-832-2418-3 |url=http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/bb10-cover.pdf |accessdate=27 March 2010}}</ref> | ||
==Classification== | |||
Adenocarcinoma of the lung may be classified according to WHO into 5 subtypes: mixed, acinar, papillary, [[bronchioloalveolar carcinoma]], and solid adenocarcinoma.<ref name="pmid4209392">{{cite journal| author=Hawkey CM| title=The relationship between blood coagulation and thrombosis and atherosclerosis in man, monkeys and carnivores. | journal=Thromb Diath Haemorrh | year= 1974 | volume= 31 | issue= 1 | pages= 103-18 | pmid=4209392 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4209392 }} </ref> Adenocarcinoma of the lung may be classified according to IASLC/ATS/ERS into 6 subtypes: pre-invasive lesions, atypical adenomatous hyperplasia, adenocarcinoma in situ, minimally invasive adenocarcinoma, invasive adenocarcinoma, and variants of invasive adenocarcinoma. | |||
==Pathophysiology== | |||
On gross pathology, peripheral multifocal lesions is the characteristic finding of adenocarcinoma of the lung.<ref>Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg </ref> On microscopic histopathological analysis, nuclear atypia, eccentrically placed nuclei, abundant cytoplasm, and conspicuous nucleoli are characteristic findings of adenocarcinoma of the lung. Genes involved in the pathogenesis of adenocarcinoma of the lung include [[epidermal growth factor receptor|EGFR]], [[HER2]], [[KRAS]], [[anaplastic lymphoma kinase|ALK]], and [[BRAF]].<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> | |||
==Cause== | |||
Adenocarcinoma of the lung may caused by genetic mutations, including [[epidermal growth factor receptor|EGFR]] (7p11), [[KRAS]] (12p12), [[BRAF]] (7q34), and PIK3CA (3q26).<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> | |||
==Differential Diagnosis== | |||
Adenocarcinoma of the lung must be differentiated from atypical adenomatous hyperplasia of the lung, adenocarcinoma in situ, [[squamous cell carcinoma of the lung]], [[small cell carcinoma of the lung]], [[malignant mesothelioma]], and metastatic adenocarcinoma.<ref name="radio">Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/Adenocarcinoma_of_the_lung</ref> | |||
==Epidemiology and Demographics== | |||
The incidence of adenocarcinoma of the lung is approximately 22.1 per 100,000 individuals worldwide.<ref name=wikipedia>Adenocarcinoma of the lung. Wikipedia 2015. https://en.wikipedia.org/wiki/Adenocarcinoma_of_the_lung#Epidemiology</ref> Adenocarcinoma of the lung affects men and women equally. Patients of all age groups may develop adenocarcinoma of the lung.<ref name="pmid19586681">{{cite journal| author=Paris C, Clement-Duchene C, Vignaud JM, Gislard A, Stoufflet A, Bertrand O et al.| title=Relationships between lung adenocarcinoma and gender, age, smoking and occupational risk factors: A case-case study. | journal=Lung Cancer | year= 2010 | volume= 68 | issue= 2 | pages= 146-53 | pmid=19586681 | doi=10.1016/j.lungcan.2009.06.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19586681 }} </ref> | |||
==Risk Factors== | |||
Common risk factors in the development of lung cancer are smoking, family history of [[lung cancer]], high levels of air pollution, radiation therapy to the chest, radon gas, [[asbestos]], occupational exposure to chemical carcinogens, and previous lung disease.<ref>Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/risks/?region=ab#Outdoor_air_pollution </ref> | |||
==Screening== | |||
According to the clinical practice guideline by the U.S. Preventive Services Task Force ([[USPSTF]]), screening for lung cancer by low-dose computed tomography (LDCT) is recommended every year among smokers and former smokers who are between 55 to 80 years old and who have smoked 30 pack-years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation).<ref name=abc>Lung Cancer Screening. U.S. Preventive Services Task Force 2015. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening Accessed on December 20, 2015</ref> According to the [[clinical practice guideline]] issued by the [[American College of Chest Physicians]] (CHEST) in 2013, screening for lung cancer by low-dose CT (LDCT) is recommended every year among smokers and former smokers who are age 55 to 74 and who have smoked for 30 pack-years or more and either continue to smoke or have quit within the past 15 years.<ref name="pmid23649455">{{cite journal| author=Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB| title=Screening for Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. | journal=Chest | year= 2013 | volume= 143 | issue= 5 Suppl | pages= e78S-92S | pmid=23649455 | doi=10.1378/chest.12-2350 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23649455 }} [http://general-medicine.jwatch.org/cgi/content/full/2013/522/2 Summary in JournalWatch]</ref> | |||
==Natural history, Complications, and Prognosis== | |||
Common complications of adenocarcinoma of the lung include [[breathing difficulties]], [[pneumonia]], [[pleural effusion]], [[metastasis]], and [[Horner's syndrome]].<ref name=mayo>Lung cancer complications. Mayo Clinic 2015. http://www.mayoclinic.org/diseases-conditions/lung-cancer/basics/complications/con-20025531 Accessed on December 20, 2015</ref> The [[prognosis]] of adenocarcinoma of the lung varies with the staging of tumor; Stage IA have the most favorable prognosis. The presence of [[metastasis]] is associated with a particularly poor prognosis. | |||
==Diagnosis== | |||
==References== | ==References== | ||
Revision as of 18:46, 6 January 2016
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Adenocarcinoma of the Lung Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]
Overview
Adenocarcinoma of the lung (pulmonary adenocarcinoma) is a common histological form of lung cancer that contains certain distinct malignant tissue architectural, cytological, or molecular features, including gland and/or duct formation and/or production of significant amounts of mucus.[1]
Classification
Adenocarcinoma of the lung may be classified according to WHO into 5 subtypes: mixed, acinar, papillary, bronchioloalveolar carcinoma, and solid adenocarcinoma.[2] Adenocarcinoma of the lung may be classified according to IASLC/ATS/ERS into 6 subtypes: pre-invasive lesions, atypical adenomatous hyperplasia, adenocarcinoma in situ, minimally invasive adenocarcinoma, invasive adenocarcinoma, and variants of invasive adenocarcinoma.
Pathophysiology
On gross pathology, peripheral multifocal lesions is the characteristic finding of adenocarcinoma of the lung.[3] On microscopic histopathological analysis, nuclear atypia, eccentrically placed nuclei, abundant cytoplasm, and conspicuous nucleoli are characteristic findings of adenocarcinoma of the lung. Genes involved in the pathogenesis of adenocarcinoma of the lung include EGFR, HER2, KRAS, ALK, and BRAF.[4]
Cause
Adenocarcinoma of the lung may caused by genetic mutations, including EGFR (7p11), KRAS (12p12), BRAF (7q34), and PIK3CA (3q26).[5]
Differential Diagnosis
Adenocarcinoma of the lung must be differentiated from atypical adenomatous hyperplasia of the lung, adenocarcinoma in situ, squamous cell carcinoma of the lung, small cell carcinoma of the lung, malignant mesothelioma, and metastatic adenocarcinoma.[6]
Epidemiology and Demographics
The incidence of adenocarcinoma of the lung is approximately 22.1 per 100,000 individuals worldwide.[7] Adenocarcinoma of the lung affects men and women equally. Patients of all age groups may develop adenocarcinoma of the lung.[8]
Risk Factors
Common risk factors in the development of lung cancer are smoking, family history of lung cancer, high levels of air pollution, radiation therapy to the chest, radon gas, asbestos, occupational exposure to chemical carcinogens, and previous lung disease.[9]
Screening
According to the clinical practice guideline by the U.S. Preventive Services Task Force (USPSTF), screening for lung cancer by low-dose computed tomography (LDCT) is recommended every year among smokers and former smokers who are between 55 to 80 years old and who have smoked 30 pack-years or more and either continue to smoke or have quit within the past 15 years (grade B recommendation).[10] According to the clinical practice guideline issued by the American College of Chest Physicians (CHEST) in 2013, screening for lung cancer by low-dose CT (LDCT) is recommended every year among smokers and former smokers who are age 55 to 74 and who have smoked for 30 pack-years or more and either continue to smoke or have quit within the past 15 years.[11]
Natural history, Complications, and Prognosis
Common complications of adenocarcinoma of the lung include breathing difficulties, pneumonia, pleural effusion, metastasis, and Horner's syndrome.[12] The prognosis of adenocarcinoma of the lung varies with the staging of tumor; Stage IA have the most favorable prognosis. The presence of metastasis is associated with a particularly poor prognosis.
Diagnosis
References
- ↑ Travis, William D; Brambilla, Elisabeth; Müller-Hermelink, H Konrad; Harris, Curtis C, eds. (2004). Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart (PDF). World Health Organization Classification of Tumours. Lyon: IARC Press. ISBN 92-832-2418-3. Retrieved 27 March 2010.
- ↑ Hawkey CM (1974). "The relationship between blood coagulation and thrombosis and atherosclerosis in man, monkeys and carnivores". Thromb Diath Haemorrh. 31 (1): 103–18. PMID 4209392.
- ↑ Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg
- ↑ 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.
- ↑ 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
- ↑ Adenocarcinoma of the lung. Wikipedia 2015. https://en.wikipedia.org/wiki/Adenocarcinoma_of_the_lung#Epidemiology
- ↑ Paris C, Clement-Duchene C, Vignaud JM, Gislard A, Stoufflet A, Bertrand O; et al. (2010). "Relationships between lung adenocarcinoma and gender, age, smoking and occupational risk factors: A case-case study". Lung Cancer. 68 (2): 146–53. doi:10.1016/j.lungcan.2009.06.007. PMID 19586681.
- ↑ Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/risks/?region=ab#Outdoor_air_pollution
- ↑ Lung Cancer Screening. U.S. Preventive Services Task Force 2015. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening Accessed on December 20, 2015
- ↑ Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB (2013). "Screening for Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 143 (5 Suppl): e78S–92S. doi:10.1378/chest.12-2350. PMID 23649455. Summary in JournalWatch
- ↑ Lung cancer complications. Mayo Clinic 2015. http://www.mayoclinic.org/diseases-conditions/lung-cancer/basics/complications/con-20025531 Accessed on December 20, 2015
