Adenocarcinoma of the lung diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]

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Overview

Biopsy is the diagnostic study of choice for adenocarcinoma of the lung. 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 varying degrees of cytologic atypia, hyperchromasia, pleomorphism and prominent nucleoli.

Diagnostic Study of Choice

  • Thoracentesis
  • 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]
  • 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:
    • Berry-shaped glands, smaller than lung acini
    • Fibrovascular cores
    • Micropapillary predominant:
    • Nipple shaped projections without fibrovascular cores
    • Solid predominant:

References

  1. Lung cancer. Canadian Cancer Society 2015.http://www.cancer.ca/en/cancer-information/cancer-type/lung/diagnosis/?region=ab#Endoscopy
  2. Kumar, Vinay (2007). Robbins basic pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 1416029737. 
  3. 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. 
  4. Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/Adenocarcinoma_of_the_lung#Microscopic Accessed on December 20, 2015



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