Adenocarcinoma of the lung diagnostic study of choice: Difference between revisions
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{{Adenocarcinoma of the lung}} | {{Adenocarcinoma of the lung}} | ||
==Overview== | ==Overview== | ||
Biopsy is the diagnostic study of choice for adenocarcinoma of the lung. 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 varying degrees of cytologic [[atypia]], hyperchromasia, [[pleomorphism]] and prominent [[nucleoli]]. | Biopsy is the diagnostic study of choice for adenocarcinoma of the lung. On microscopic [[Histopathology|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 varying degrees of cytologic [[atypia]], hyperchromasia, [[pleomorphism]] and prominent [[nucleoli]]. | ||
==Diagnostic Study of Choice== | ==Diagnostic Study of Choice== | ||
* [[Biopsy]] is helpful in the diagnosis of adenocarcinoma of the lung. | * [[Biopsy]] is helpful in the diagnosis of adenocarcinoma of the lung. | ||
** [[Fine needle aspiration]] (FNA)<ref name="cancada">Lung cancer. Canadian Cancer Society 2015.http://www.cancer.ca/en/cancer-information/cancer-type/lung/diagnosis/?region=ab#Endoscopy</ref>: | ** [[Fine needle aspiration]] (FNA)<ref name="cancada">Lung cancer. Canadian Cancer Society 2015.http://www.cancer.ca/en/cancer-information/cancer-type/lung/diagnosis/?region=ab#Endoscopy</ref>: | ||
*** CT guided FNA uses a small amount of tissue from a suspected lung | *** [[FNA|CT guided FNA]] uses a small amount of tissue from a suspected lung [[tumor]] 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. | *** [[Needle aspiration biopsy|FNA]] may also be obtained during [[bronchoscopy]], along with [[Ultrasound|endobronchial ultrasound]], to take samples of [[Lymph node|lymph nodes]] around the [[Vertebrate trachea|trachea]] and [[Bronchus|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|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. | :* On microscopic [[Histopathology|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. | :* 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]] | :** Varying degrees of cytologic [[atypia]] | ||
:** Hyperchromasia | :** Hyperchromasia | ||
Latest revision as of 14:49, 6 March 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
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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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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
- 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 tumor 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