Adenocarcinoma of the lung pathophysiology: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 58: Line 58:


==Gross Pathology==
==Gross Pathology==
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
* On gross pathology, peripheral multifocal lesions are characteristic findings in patients with adenocarcinoma of the lung.<ref>Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg </ref>
* Peripheral lesions
* May be multifocal
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.
* Adenocarcinoma of the lung tends to stain mucin positive as it is derived from the mucus producing glands of the lungs. Similar to other adenocarcinoma, if this tumor is well differentiated (low grade) it will resemble the normal glandular structure. Poorly differentiated adenocarcinoma will not resemble the normal glands (high grade) and will be detected by seeing that they stain positive for mucin (which the glands produce).<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>
 
* To reveal the adenocarcinomatous lineage of the solid variant, demonstration of intracellular mucin production may be performed. Foci of squamous metaplasia and dysplasia may be present in the epithelium proximal to adenocarcinomas, but these are not the precursor lesions for this tumor. Rather, the precursor of peripheral adenocarcinomas has been termed atypical adenomatous hyperplasia (AAH). Microscopically, AAH is a well-demarcated focus of epithelial proliferation, containing cuboidal to low-columnar cells resembling club cells or type II pneumocytes. These demonstrate various degrees of cytologic atypia, including hyperchromasia, pleomorphism, prominent [[nucleoli]]. Lesions of AAH are monoclonal, and they share many of the molecular aberrations that are associated with adenocarcinomas.<ref>{{cite book | last = Kumar | first = Vinay | title = Robbins basic pathology | publisher = Saunders/Elsevier | location = Philadelphia, PA | year = 2007 | isbn = 1416029737 }}</ref>


==Microscopic Pathology==
==Microscopic Pathology==
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
* Nuclear atypia
*Atypical adenomatous hyperplasia (AAH): is the precursor of peripheral adenocarcinomas.  It consists of well demarcated columnar or 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
*Hyperchromasia
*Pleomorphism
*Prominent [[nucleoli]]
*
*
*Nuclear atypia
* Eccentrically placed nuclei
* Eccentrically placed nuclei
* Abundant cytoplasm
* Abundant cytoplasm
Line 74: Line 75:
* Nuclear pseudoinclusions
* Nuclear pseudoinclusions
* Lack of intercellular bridges
* Lack of intercellular bridges
* On microscopic histopathological analysis, nuclear atypia, eccentrically placed nuclei, abundant cytoplasm, and conspicuous nucleoli are characteristic findings of adenocarcinoma of the lung.
* 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'''<ref name="libre">Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/Adenocarcinoma_of_the_lung#Microscopic Accessed on December 20, 2015</ref>
'''Subtypes'''<ref name="libre">Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/Adenocarcinoma_of_the_lung#Microscopic Accessed on December 20, 2015</ref>

Revision as of 18:04, 2 March 2018

Adenocarcinoma of the Lung Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Adenocarcinoma of the Lung from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Intervention

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Adenocarcinoma of the lung pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Adenocarcinoma of the lung pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Adenocarcinoma of the lung pathophysiology

CDC on Adenocarcinoma of the lung pathophysiology

Adenocarcinoma of the lung pathophysiology in the news

Blogs on Adenocarcinoma of the lung pathophysiology

Directions to Hospitals Treating Adenocarcinoma of the lung

Risk calculators and risk factors for Adenocarcinoma of the lung pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Overview

Genes involved in the pathogenesis of adenocarcinoma of the lung include EGFR, HER2, KRAS, ALK, and BRAF.[1] The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR


[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathogenesis

  • Adenocarcinoma is the most common type of lung cancer found in non-smokers and is usually seen as a peripheral lesion in the lungs, as compared to centrally located tumors such as small cell lung cancer and squamous cell lung cancer.[2][3]

Genetics

Associated Conditions

Gross Pathology

  • On gross pathology, peripheral multifocal lesions are characteristic findings in patients with adenocarcinoma of the lung.[7]

Microscopic Pathology

  • On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
  • Atypical adenomatous hyperplasia (AAH): is the precursor of peripheral adenocarcinomas. It consists of well demarcated columnar or cuboidal cells with the following features:[8][9]
  • Varying degrees of cytologic atypia
  • Hyperchromasia
  • Pleomorphism
  • Prominent nucleoli
  • Nuclear atypia
  • Eccentrically placed nuclei
  • Abundant cytoplasm
  • Conspicuous nucleoli
  • Nuclear pseudoinclusions
  • Lack of intercellular bridges
  • On microscopic histopathological analysis, nuclear atypia, eccentrically placed nuclei, abundant cytoplasm, and conspicuous nucleoli are characteristic findings of adenocarcinoma of the lung.
  • 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[10]

  • Lepidic predominant
  • Tumor grows long the alveolar wall
  • 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


Gross pathology

Gallery

Microscopic Pathology

Gallery

References

  1. 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.
  2. Travis WD, Travis LB, Devesa SS (January 1995). "Lung cancer". Cancer. 75 (1 Suppl): 191–202. doi:10.1002/1097-0142(19950101)75:1+<191::AID-CNCR2820751307>3.0.CO;2-Y. PMID 8000996.
  3. Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson. "Chapter 13, box on morphology of adenocarcinoma". Robbins Basic Pathology (8th ed.). Philadelphia: Saunders. ISBN 1-4160-2973-7.
  4. 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.
  5. Soda M, Choi YL, Enomoto M, Takada S, Yamashita Y, Ishikawa S; et al. (2007). "Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer". Nature. 448 (7153): 561–6. doi:10.1038/nature05945. PMID 17625570.
  6. Davies KD, Le AT, Theodoro MF, Skokan MC, Aisner DL, Berge EM; et al. (2012). "Identifying and targeting ROS1 gene fusions in non-small cell lung cancer". Clin Cancer Res. 18 (17): 4570–9. doi:10.1158/1078-0432.CCR-12-0550. PMC 3703205. PMID 22919003.
  7. Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg
  8. Kumar, Vinay (2007). Robbins basic pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 1416029737.
  9. 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.
  10. Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/Adenocarcinoma_of_the_lung#Microscopic Accessed on December 20, 2015
  11. Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg
  12. Acinar adenocarcinoma. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Mucinous_adenocarcinoma_of_the_lung_--_high_mag.jpg
  13. Mucinous adenocarcinoma. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Acinar_pattern_adenocarcinoma_of_lung_--_intermed_mag.jpg


Template:WikiDoc Sources