Adenocarcinoma of the lung classification

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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 may be classified according to WHO into 5 subtypes: mixed, acinar, papillary, bronchioloalveolar carcinoma, and solid adenocarcinoma.[1] 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.

Classification

  • Adenocarcinomas are highly heterogeneous tumors. Several major histological subtypes are currently recognized by the WHO[1] and IASLC/ATS/ERS[2][3][4]
  • In as many as 80% of tumors that are extensively sampled, components of more than one of these subtypes will be recognized. 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]

2004 WHO classification

  • Non mucinous
  • Mucinous
  • Mixed
  • Solid adenocarcinoma

IASLC/ATS/ERS classification

  • Pre-invasive lesions
  • Atypical adenomatous hyperplasia
  • Adenocarcinoma in situ of lung
  • Non-mucinous
  • Mucinous
  • Mixed
  • Minimally invasive adenocarcinoma
  • Non-mucinous
  • Mucinous
  • Mixed
  • Invasive adenocarcinoma
  • Lepidic predominant
  • Acinar predominant
  • Papillary predominant
  • Micropapillary predominant
  • Solid predominant with mucin production
  • Variants of invasive adenocarcinoma
  • Invasive mucinous adenocarcinoma
  • Colloid
  • Fetal
  • Enteric

References

  1. 1.0 1.1 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. 
  2. 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. PMID 21828029. doi:10.1183/09031936.00027511. 
  3. 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. PMID 21804158. doi:10.1183/09031936.00026711. 
  4. 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. PMC 2849638Freely accessible. PMID 18951650. doi:10.1016/j.lungcan.2008.08.009. 
  5. 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. PMID 21252716. doi:10.1097/JTO.0b013e318206a221. 
  6. 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. PMID 21642859. doi:10.1097/JTO.0b013e318221f701. 

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