Back to Search
Start Over
Micropapillary adenocarcinoma of lung: Morphological criteria and diagnostic reproducibility among pulmonary pathologists
- Source :
- Annals of Diagnostic Pathology. 41:43-50
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Context Invasive micropapillary adenocarcinoma (MPC) is an aggressive variant of lung adenocarcinoma, frequently manifesting with advanced stage lymph node metastasis and decreased survival. Objective Identification of this morphology is important, as it is strongly correlated with poor prognosis regardless of the amount of MPC component. To date, no study has investigated the morphological criteria used to objectively diagnose it. Design Herein, we selected 30 cases of potential MPC of lung, and distributed 2 digital images per case among 15 pulmonary pathology experts. Reviewers were requested to diagnostically interpret, assign the percentage of MPC component, and record the morphological features they identified. The noted features included: columnar cells, elongated slender cell nests, extensive stromal retraction, lumen formation with internal epithelial tufting, epithelial signet ring-like forms, intracytoplasmic vacuolization, multiple nests in the same alveolar space, back-to-back lacunar spaces, epithelial nest anastomosis, marked pleomorphism, peripherally oriented nuclei, randomly distributed nuclei, small/medium/large tumor nest size, fibrovascular cores, and spread through air-spaces (STAS). Results Cluster analysis revealed three subgroups with the following diagnoses: “MPC”, “combined papillary and MPC”, and “others”. The subgroups correlated with the reported median percentage of MPC. Intracytoplasmic vacuolization, epithelial nest anastomosis/confluence, multiple nests in the same alveolar space, and small/medium tumor nest size were the most common criteria identified in the cases diagnosed as MPC. Peripherally oriented nuclei and epithelial signet ring-like forms were frequently identified in both the “MPC” and “combined papillary and MPC” groups. Conclusions Our study provides objective diagnostic criteria to diagnose MPC of lung.
- Subjects :
- Adult
Male
0301 basic medicine
Pathology
medicine.medical_specialty
Lung Neoplasms
Stromal cell
Pathology, Surgical
Columnar Cell
Anastomosis
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
immune system diseases
medicine
Humans
Pulmonary pathology
Aged
Lung
business.industry
Reproducibility of Results
General Medicine
Middle Aged
medicine.disease
Pathologists
Adenocarcinoma, Papillary
030104 developmental biology
medicine.anatomical_structure
Vacuolization
Pleomorphism (cytology)
030220 oncology & carcinogenesis
Adenocarcinoma
Female
business
Subjects
Details
- ISSN :
- 10929134
- Volume :
- 41
- Database :
- OpenAIRE
- Journal :
- Annals of Diagnostic Pathology
- Accession number :
- edsair.doi.dedup.....471fdfef3cbe6f6188e09b0ebac02435
- Full Text :
- https://doi.org/10.1016/j.anndiagpath.2019.04.008