Adenocarcinoma of the lung classification: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
 
(8 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Adenocarcinoma of the lung}}
{{Adenocarcinoma of the lung}}
{{CMG}}; {{AE}} {{SC}}
{{CMG}}; {{AE}} {{Trusha}}{{SC}} {{Cherry}}
==Overview==
==Overview==
Adenocarcinoma of the lung may be classified according to WHO into 5 subtypes: mixed, acinar, papillary, [[bronchioloalveolar carcinoma]], and solid adenocarcinoma.<ref name="pmid4209392">{{cite journal| author=Hawkey CM| title=The relationship between blood coagulation and thrombosis and atherosclerosis in man, monkeys and carnivores. | journal=Thromb Diath Haemorrh | year= 1974 | volume= 31 | issue= 1 | pages= 103-18 | pmid=4209392 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4209392  }} </ref> 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.
Adenocarcinoma of the lung may be [[Classification|classified]] according to [[World Health Organization|WHO]] into many sub-types. Adenocarcinoma of the lung may be [[Classification|classified]] according to IASLC/ATS/ERS into pre-invasive [[Lesion|lesions]], [[Atypical adenomatous hyperplasia of the lung|atypical adenomatous hyperplasia]], adenocarcinoma in situ, minimally invasive adenocarcinoma, invasive adenocarcinoma, and variants of invasive adenocarcinoma.


==Classification==
==Classification==
* Adenocarcinomas are highly heterogeneous tumors. Several major histological subtypes are currently recognized by the WHO<ref name="pmid4209392">{{cite journal| author=Hawkey CM| title=The relationship between blood coagulation and thrombosis and atherosclerosis in man, monkeys and carnivores. | journal=Thromb Diath Haemorrh | year= 1974 | volume= 31 | issue= 1 | pages= 103-18 | pmid=4209392 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4209392  }} </ref> and IASLC/ATS/ERS classification systems.<ref name="pmid21828029">{{Cite journal | pmid = 21828029| year = 2012| author1 = Van Schil| first1 = P. E.| title = Surgical implications of the new IASLC/ATS/ERS adenocarcinoma classification| journal = European Respiratory Journal| volume = 39| issue = 2| pages = 478-86| last2 = Asamura| first2 = H| last3 = Rusch| first3 = V. W.| last4 = Mitsudomi| first4 = T| last5 = Tsuboi| first5 = M| last6 = Brambilla| first6 = E| last7 = Travis| first7 = W. D.| doi = 10.1183/09031936.00027511}}</ref><ref>{{Cite journal | pmid = 21804158| year = 2011| author1 = Travis| first1 = W. D.| title = Paradigm shifts in lung cancer as defined in the new IASLC/ATS/ERS lung adenocarcinoma classification| journal = European Respiratory Journal| volume = 38| issue = 2| pages = 239-43| last2 = Brambilla| first2 = E| last3 = Van Schil| first3 = P| last4 = Scagliotti| first4 = G. V.| last5 = Huber| first5 = R. M.| last6 = Sculier| first6 = J. P.| last7 = Vansteenkiste| first7 = J| last8 = Nicholson| first8 = A. G.| doi = 10.1183/09031936.00026711}}</ref><ref>{{Cite journal | pmid = 18951650| year = 2009| author1 = Vazquez| first1 = M| title = Solitary and multiple resected adenocarcinomas after CT screening for lung cancer: Histopathologic features and their prognostic implications| journal = Lung Cancer| volume = 64| issue = 2| pages = 148-54| last2 = Carter| first2 = D| last3 = Brambilla| first3 = E| last4 = Gazdar| first4 = A| last5 = Noguchi| first5 = M| last6 = Travis| first6 = W. D.| last7 = Huang| first7 = Y| last8 = Zhang| first8 = L| last9 = Yip| first9 = R| last10 = Yankelevitz| first10 = D. F.| last11 = Henschke| first11 = C. I.| author12 = International Early Lung Cancer Action Program Investigators| doi = 10.1016/j.lungcan.2008.08.009| pmc = 2849638}}</ref>
* Adenocarcinomas are highly [[heterogeneous]] [[Tumor|tumors]].  
* Several major [[Histology|histological]] sub-types are currently recognized by the [[World Health Organization|WHO]] and IASLC/ATS/ERS [[classification]] systems.<ref name="pmid21828029">{{Cite journal | pmid = 21828029| year = 2012| author1 = Van Schil| first1 = P. E.| title = Surgical implications of the new IASLC/ATS/ERS adenocarcinoma classification| journal = European Respiratory Journal| volume = 39| issue = 2| pages = 478-86| last2 = Asamura| first2 = H| last3 = Rusch| first3 = V. W.| last4 = Mitsudomi| first4 = T| last5 = Tsuboi| first5 = M| last6 = Brambilla| first6 = E| last7 = Travis| first7 = W. D.| doi = 10.1183/09031936.00027511}}</ref><ref>{{Cite journal | pmid = 21804158| year = 2011| author1 = Travis| first1 = W. D.| title = Paradigm shifts in lung cancer as defined in the new IASLC/ATS/ERS lung adenocarcinoma classification| journal = European Respiratory Journal| volume = 38| issue = 2| pages = 239-43| last2 = Brambilla| first2 = E| last3 = Van Schil| first3 = P| last4 = Scagliotti| first4 = G. V.| last5 = Huber| first5 = R. M.| last6 = Sculier| first6 = J. P.| last7 = Vansteenkiste| first7 = J| last8 = Nicholson| first8 = A. G.| doi = 10.1183/09031936.00026711}}</ref><ref>{{Cite journal | pmid = 18951650| year = 2009| author1 = Vazquez| first1 = M| title = Solitary and multiple resected adenocarcinomas after CT screening for lung cancer: Histopathologic features and their prognostic implications| journal = Lung Cancer| volume = 64| issue = 2| pages = 148-54| last2 = Carter| first2 = D| last3 = Brambilla| first3 = E| last4 = Gazdar| first4 = A| last5 = Noguchi| first5 = M| last6 = Travis| first6 = W. D.| last7 = Huang| first7 = Y| last8 = Zhang| first8 = L| last9 = Yip| first9 = R| last10 = Yankelevitz| first10 = D. F.| last11 = Henschke| first11 = C. I.| author12 = International Early Lung Cancer Action Program Investigators| doi = 10.1016/j.lungcan.2008.08.009| pmc = 2849638}}</ref>
*The IASLC/ATS/ERS lung adenocarcinoma [[Histology|histological]] [[classification]] system was proposed in 2011.<ref>{{cite journal|doi=10.3978/j.issn.2072-1439.2014.09.13}}</ref>
*According to this new [[classification]], [[tumor]] size ≤ 3 cm with pure lepidic pattern, but without [[Lymph node metastases|lymphatic]], [[vascular]], and [[Pleura|pleural]] [[Invasive (medical)|invasion]] or tumor [[necrosis|necrosis,]] was defined as adenocarcinoma ''in situ'' (AIS).
*If [[tumor]] size ≤ 3 cm with a lepidic predominant pattern and contained ≤ 5 mm [[stromal]] [[Invasive (medical)|invasion]], it was defined as minimally invasive adenocarcinoma (MIA).
*If tumor had > 5 mm [[stromal]] [[Invasive (medical)|invasion]], it was defined as an invasive adenocarcinoma.
 
* The [[World Health Organization|WHO]] [[Histology|histological]] [[classification]] of adenocarcinoma is following:<ref name="WHO">{{cite book | last = Travis | first = William | title = Pathology and genetics of tumours of the lung, pleura, thymus, and heart | publisher = IARC Press | location = Lyon | year = 2004 | isbn = 9283224183 }}</ref><ref name="urlwww.jto.org">{{cite web |url=https://www.jto.org/article/S1556-0864(15)33571-1/pdf |title=www.jto.org |format= |work= |accessdate=}}</ref>


* 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.<ref>{{Cite journal | pmid = 21252716| year = 2011| author1 = Travis| first1 = W. D.| title = International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma| journal = Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer| volume = 6| issue = 2| pages = 244–85| last2 = Brambilla| first2 = E| last3 = Noguchi| first3 = M| last4 = Nicholson| first4 = A. G.| last5 = Geisinger| first5 = K. R.| last6 = Yatabe| first6 = Y| last7 = Beer| first7 = D. G.| last8 = Powell| first8 = C. A.| last9 = Riely| first9 = G. J.| last10 = Van Schil| first10 = P. E.| last11 = Garg| first11 = K| last12 = Austin| first12 = J. H.| last13 = Asamura| first13 = H| last14 = Rusch| first14 = V. W.| last15 = Hirsch| first15 = F. R.| last16 = Scagliotti| first16 = G| last17 = Mitsudomi| first17 = T| last18 = Huber| first18 = R. M.| last19 = Ishikawa| first19 = Y| last20 = Jett| first20 = J| last21 = Sanchez-Cespedes| first21 = M| last22 = Sculier| first22 = J. P.| last23 = Takahashi| first23 = T| last24 = Tsuboi| first24 = M| last25 = Vansteenkiste| first25 = J| last26 = Wistuba| first26 = I| last27 = Yang| first27 = P. C.| last28 = Aberle| first28 = D| last29 = Brambilla| first29 = C| last30 = Flieder| first30 = D| display-authors = 29| doi = 10.1097/JTO.0b013e318206a221}}</ref> The predominant subtype is prognostic for survival after complete resection.<ref>{{Cite journal | pmid = 21642859| year = 2011| author1 = Russell| first1 = P. A.| title = 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 = Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer| volume = 6| issue = 9| pages = 1496–504| last2 = Wainer| first2 = Z| last3 = Wright| first3 = G. M.| last4 = Daniels| first4 = M| last5 = Conron| first5 = M| last6 = Williams| first6 = R. A.| doi = 10.1097/JTO.0b013e318221f701}}</ref>
* The classification systems for adenocarcinoma of the lung are described below.
{| class="wikitable"
{| class="wikitable"
!style="background:#4479BA; color: #FFFFFF;"|WHO
|+
!style="background:#4479BA; color: #FFFFFF;"|'''IASLC/ATS/ERS'''
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" ! | WHO Classification of Lung Tumors
|-
|-
|
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histological type
* Mixed subtype
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Subtype
* Acinar
* Papillary
|
* Pre-invasive lesions
 
* Atypical adenomatous hyperplasia
|-
|-
|
! colspan="2" style="background: #707070; color: #FFFFFF; text-align: center;" |Epithelial Tumors
* [[Bronchioloalveolar carcinoma]]
** Non mucinous
** Mucinous
** Mixed
|
* Adenocarcinoma in situ of lung
** Non-mucinous
** Mucinous
** Mixed
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Adenocarcinoma of the lung|'''Adenocarcinoma''']]
|
|
* Lepidic adenocarcinoma
* Acinar adenocarcinoma
* Papillary adenocarcinoma
* Micropapillary adenocarcinoma
* Solid adenocarcinoma
* Solid adenocarcinoma
:* Colloid
* Invasive mucinous adenocarcinoma
:* Fetal
** Mixed invasive mucinous
:* [[Mucinous cystadenocarcinoma]]
** Nonmucinous adenocarcinoma
:* Signet-ring
* Colloid adenocarcinoma
:* Clear-cell
* Fetal adenocarcinoma
|
* Enteric adenocarcinoma
* Minimally invasive adenocarcinoma
* Minimally invasive adenocarcinoma
:* Non-mucinous
* Nonmucinous
 
** Mucinous
:* Mucinous
* Preinvasive lesions
 
** Atypical adenomatous hyperplasia
:* Mixed
** Adenocarcinoma in situ
|-
*** Nonmucinous
|
*** Mucinous
|
* 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==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 19:34, 17 September 2019

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 classification 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 classification

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 classification

CDC on Adenocarcinoma of the lung classification

Adenocarcinoma of the lung classification in the news

Blogs on Adenocarcinoma of the lung classification

Directions to Hospitals Treating Adenocarcinoma of the lung

Risk calculators and risk factors for Adenocarcinoma of the lung classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]Shanshan Cen, M.D. [3] Sudarshana Datta, MD [4]

Overview

Adenocarcinoma of the lung may be classified according to WHO into many sub-types. Adenocarcinoma of the lung may be classified according to IASLC/ATS/ERS into pre-invasive lesions, atypical adenomatous hyperplasia, adenocarcinoma in situ, minimally invasive adenocarcinoma, invasive adenocarcinoma, and variants of invasive adenocarcinoma.

Classification

WHO Classification of Lung Tumors
Histological type Subtype
Epithelial Tumors
Adenocarcinoma
  • Lepidic adenocarcinoma
  • Acinar adenocarcinoma
  • Papillary adenocarcinoma
  • Micropapillary adenocarcinoma
  • Solid adenocarcinoma
  • Invasive mucinous adenocarcinoma
    • Mixed invasive mucinous
    • Nonmucinous adenocarcinoma
  • Colloid adenocarcinoma
  • Fetal adenocarcinoma
  • Enteric adenocarcinoma
  • Minimally invasive adenocarcinoma
  • Nonmucinous
    • Mucinous
  • Preinvasive lesions
    • Atypical adenomatous hyperplasia
    • Adenocarcinoma in situ
      • Nonmucinous
      • Mucinous

References

  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.
  2. 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.
  3. 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.
  4. . doi:10.3978/j.issn.2072-1439.2014.09.13. Missing or empty |title= (help)
  5. Travis, William (2004). Pathology and genetics of tumours of the lung, pleura, thymus, and heart. Lyon: IARC Press. ISBN 9283224183.
  6. "www.jto.org".


Template:WikiDoc Sources