Adenocarcinoma of the lung classification
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Adenocarcinoma of the Lung Microchapters |
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Differentiating Adenocarcinoma of the Lung from other Diseases |
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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
Classification
Adenocarcinomas are highly heterogeneous tumors. Several major histological subtypes are currently recognized by the WHO[1] and IASLC/ATS/ERS[2][3][4]
- Non-invasive or minimally invasive adenocarcinoma
- Invasive adenocarcinoma
- Acinar predominant adenocarcinoma
- Papillary predominant adenocarcinoma
- Micropapillary predominant adenocarcinoma
- Solid predominant adenocarcinoma
- Invasive mucinous adenocarcinoma
In as many as 80% of tumors that are extensively sampled, components of more than one of these subtypes will be recognized. In such cases, resected tumors should be classified by comprehensive histological subtyping. Using increments of 5% to describe the amount of each subtype present, the predominant subtype is used to classify the whole tumor.[5] The predominant subtype is prognostic for survival after complete resection.[6]
Signet ring and clear cell adenocarcinoma are no longer histological subtypes, but rather cytological features that can occur in tumour cells of multiple histological subtypes, most often solid adenocarcinoma.[2]
Some variants are not clearly recognized by the WHO and IASLC/ATS/ERS classification:
- Enteric adenocarcinoma of the lung[7][8]
- Cribriform adenocarcinoma of the lung
2004 WHO classification
- Mixed subtype
- Acinar
- Papillary
- Bronchioloalveolar carcinoma
- Non mucinous
- Mucinous
- Mixed
- Solid adenocarcinoma
- Colloid
- Fetal
- Mucinous cystadenocarcinoma
- Signet-ring
- Clear-cell
IASLC/ATS/ERS classification
- Pre-invasive lesions
- Atypical adenomatous hyperplasia
- AIS
- Non-mucinous
- Mucinous
- Mixed
- MIA
- Non-mucinous
- Mucinous
- Mixed
- Invasive adenocarcinomas
- Lepidic predominant
- Acinar predominant
- Papillary predominant
- Micropapillary predominant
- Solid predominant with mucin production
- Variants of invasive adenocarcinomas
- IMA
- Colloid
- Fetal
- Enteric
References
- ↑ Travis, William (2004). Pathology and genetics of tumours of the lung, pleura, thymus, and heart. Lyon: IARC Press. ISBN 9283224183.
- ↑ 2.0 2.1 Van Schil, P. E.; Asamura, H; Rusch, V. W.; Mitsudomi, T; Tsuboi, M; Brambilla, E; Travis, W. D. (2012). "Surgical implications of the new IASLC/ATS/ERS adenocarcinoma classification". European Respiratory Journal. 39 (2): 478–86. doi:10.1183/09031936.00027511. PMID 21828029.
- ↑ Travis, W. D.; Brambilla, E; Van Schil, P; Scagliotti, G. V.; Huber, R. M.; Sculier, J. P.; Vansteenkiste, J; Nicholson, A. G. (2011). "Paradigm shifts in lung cancer as defined in the new IASLC/ATS/ERS lung adenocarcinoma classification". European Respiratory Journal. 38 (2): 239–43. doi:10.1183/09031936.00026711. PMID 21804158.
- ↑ Vazquez, M; Carter, D; Brambilla, E; Gazdar, A; Noguchi, M; Travis, W. D.; Huang, Y; Zhang, L; Yip, R; Yankelevitz, D. F.; Henschke, C. I.; International Early Lung Cancer Action Program Investigators (2009). "Solitary and multiple resected adenocarcinomas after CT screening for lung cancer: Histopathologic features and their prognostic implications". Lung Cancer. 64 (2): 148–54. doi:10.1016/j.lungcan.2008.08.009. PMC 2849638. PMID 18951650.
- ↑ Travis, W. D.; Brambilla, E; Noguchi, M; Nicholson, A. G.; Geisinger, K. R.; Yatabe, Y; Beer, D. G.; Powell, C. A.; Riely, G. J.; Van Schil, P. E.; Garg, K; Austin, J. H.; Asamura, H; Rusch, V. W.; Hirsch, F. R.; Scagliotti, G; Mitsudomi, T; Huber, R. M.; Ishikawa, Y; Jett, J; Sanchez-Cespedes, M; Sculier, J. P.; Takahashi, T; Tsuboi, M; Vansteenkiste, J; Wistuba, I; Yang, P. C.; Aberle, D; Brambilla, C; et al. (2011). "International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma". Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 6 (2): 244–85. doi:10.1097/JTO.0b013e318206a221. PMID 21252716.
- ↑ Russell, P. A.; Wainer, Z; Wright, G. M.; Daniels, M; Conron, M; Williams, R. A. (2011). "Does lung adenocarcinoma subtype predict patient survival?: A clinicopathologic study based on the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary lung adenocarcinoma classification". Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 6 (9): 1496–504. doi:10.1097/JTO.0b013e318221f701. PMID 21642859.
- ↑ Yousem, S. A. (2005). "Pulmonary intestinal-type adenocarcinoma does not show enteric differentiation by immunohistochemical study". Modern Pathology. 18 (6): 816–21. doi:10.1038/modpathol.3800358. PMID 15605076.
- ↑ Lin, D; Zhao, Y; Li, H; Xing, X (2013). "Pulmonary enteric adenocarcinoma with villin brush border immunoreactivity: A case report and literature review". Journal of thoracic disease. 5 (1): E17–20. doi:10.3978/j.issn.2072-1439.2012.06.06. PMC 3547996. PMID 23372961.