Difference between revisions of "Adenosquamous carcinoma of the lung"

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'''Adenosquamous carcinoma of the lung''' is a rare epithelial derived [[malignancy]] of the [[lung]] with features of both [[adenocarcinoma of the lung|adenocarcinoma]] and [[squamous cell carcinoma of the lung|squamous cell carcinoma]].   
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Adenosquamous carcinoma of lung -- high mag.jpg
| Width      =
| Caption    = Adenosquamous carcinoma of lung. [[H&E stain]].
| Synonyms  =
| Micro      =
| Subtypes  =
| LMDDx      = [[squamous cell carcinoma of the lung]], [[adenocarcinoma of the lung]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[lung]] - see ''[[lung tumours]]''
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    = other [[lung tumours]]
| Tx        =
}}
'''Adenosquamous carcinoma of the lung''', also '''lung adenosquamous carcinoma''', is a rare epithelial derived [[malignancy]] of the [[lung]] with features of both [[adenocarcinoma of the lung|adenocarcinoma]] and [[squamous cell carcinoma of the lung|squamous cell carcinoma]].   


It is grouped with the [[non-small cell lung cancer]]s.
It is grouped with the [[non-small cell lung cancer]]s.


==General==
==General==
*Respond to [[tyroxine kinase inhibitors]].<ref name=pmid23769878>{{Cite journal  | last1 = Song | first1 = Z. | last2 = Lin | first2 = B. | last3 = Shao | first3 = L. | last4 = Zhang | first4 = Y. | title = Therapeutic efficacy of gefitinib and erlotinib in patients with advanced lung adenosquamous carcinoma. | journal = J Chin Med Assoc | volume = 76 | issue = 9 | pages = 481-5 | month = Sep | year = 2013 | doi = 10.1016/j.jcma.2013.05.007 | PMID = 23769878 }}</ref>
*Rare.
*Respond to [[tyrosine kinase inhibitors]].<ref name=pmid23769878>{{Cite journal  | last1 = Song | first1 = Z. | last2 = Lin | first2 = B. | last3 = Shao | first3 = L. | last4 = Zhang | first4 = Y. | title = Therapeutic efficacy of gefitinib and erlotinib in patients with advanced lung adenosquamous carcinoma. | journal = J Chin Med Assoc | volume = 76 | issue = 9 | pages = 481-5 | month = Sep | year = 2013 | doi = 10.1016/j.jcma.2013.05.007 | PMID = 23769878 }}</ref><ref name=pmid23037472>{{Cite journal  | last1 = Iwanaga | first1 = K. | last2 = Sueoka-Aragane | first2 = N. | last3 = Nakamura | first3 = T. | last4 = Mori | first4 = D. | last5 = Kimura | first5 = S. | title = The long-term survival of a patient with adenosquamous lung carcinoma harboring EGFR-activating mutations who was treated with gefitinib. | journal = Intern Med | volume = 51 | issue = 19 | pages = 2771-4 | month =  | year = 2012 | doi =  | PMID = 23037472 }}</ref>


==Microscopic==
==Microscopic==
Features:
Features:<ref name=pmid25002356>{{Cite journal  | last1 = Rao | first1 = N. | title = Adenosquamous carcinoma. | journal = Semin Diagn Pathol | volume = 31 | issue = 4 | pages = 271-7 | month = Jul | year = 2014 | doi = 10.1053/j.semdp.2014.06.004 | PMID = 25002356 }}</ref><ref name=pmid26068980>{{cite journal |authors=Vassella E, Langsch S, Dettmer MS, Schlup C, Neuenschwander M, Frattini M, Gugger M, Schäfer SC |title=Molecular profiling of lung adenosquamous carcinoma: hybrid or genuine type? |journal=Oncotarget |volume=6 |issue=27 |pages=23905–16 |date=September 2015 |pmid=26068980 |pmc=4695160 |doi=10.18632/oncotarget.4163 |url=}}</ref>
#Adenocarcinoma component.
#Adenocarcinoma component (>=10% of tumour ‡).
#Squamous cell carcinoma component.
#Squamous cell carcinoma component (>=10% of tumour ‡).
 
Note:
*‡ Criteria used by individual pathologists may vary and/or may not be uniformly applied.<ref name=pmid25002356>{{Cite journal  | last1 = Rao | first1 = N. | title = Adenosquamous carcinoma. | journal = Semin Diagn Pathol | volume = 31 | issue = 4 | pages = 271-7 | month = Jul | year = 2014 | doi = 10.1053/j.semdp.2014.06.004 | PMID = 25002356 }}</ref>
 
DDx:
*[[Squamous cell carcinoma of the lung]].
*[[Adenocarcinoma of the lung]].
*Metastatic [[adenosquamous carcinoma]] - requires history.
 
===Images===
<gallery>
Image: Adenosquamous carcinoma of lung -- intermed mag.jpg | ASC - intermed. mag.  (WC)
Image: Adenosquamous carcinoma of lung - alt -- intermed mag.jpg | ASC - intermed. mag. (WC)
Image: Adenosquamous carcinoma of lung -- high mag.jpg | ASC - high mag. (WC)
Image: Adenosquamous carcinoma of lung -- very high mag.jpg | ASC - very high mag. (WC)
</gallery>
====www====
*[http://www.webpathology.com/image.asp?case=415&n=21 Lung adenosquamous carcinoma (webpathology.com)].
*[https://www.flickr.com/photos/pulmonary_pathology/7491350926/ Lung adenosquamous carcinoma (flickr.com/Yale Rosen)].
 
==Sign out==
===Biopsy - possible adenosquamous carcinoma===
<pre>
Left Upper Lobe of Lung, Core Biopsy:
    - NONSMALL CELL CARCINOMA, FAVOUR ADENOCARCINOMA, CANNOT EXCLUDE ADENOSQUAMOUS CARCINOMA.
 
Comment:
The tumour stains as follow:
POSITIVE: TTF-1, CK5/6 (focal), p63, napsin A.
NEGATIVE: (none).
 
The positive staining (TTF-1 and napsin A versus CK5/6 and p63) appears to be in different tumour cells. 
 
The case was reviewed internally and there is agreement on the above interpretation.
</pre>
 
Note:
*Cases should not be signed as ''adenosquamous carcinoma'' on biopsy, due to the percentage requirements (>=10% for both components) - see ''microscopic'' section.


==See also==
==See also==
Line 15: Line 86:
*[[Lung tumours]].
*[[Lung tumours]].
*[[Adenosquamous carcinoma]].
*[[Adenosquamous carcinoma]].
*[[Non-small cell lung carcinoma]].


==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Lung tumours]]
[[Category:Lung tumours]]

Latest revision as of 14:48, 6 April 2023

Adenosquamous carcinoma of the lung
Diagnosis in short

Adenosquamous carcinoma of lung. H&E stain.
LM DDx squamous cell carcinoma of the lung, adenocarcinoma of the lung
Site lung - see lung tumours
Prevalence rare
Clin. DDx other lung tumours

Adenosquamous carcinoma of the lung, also lung adenosquamous carcinoma, is a rare epithelial derived malignancy of the lung with features of both adenocarcinoma and squamous cell carcinoma.

It is grouped with the non-small cell lung cancers.

General

Microscopic

Features:[3][4]

  1. Adenocarcinoma component (>=10% of tumour ‡).
  2. Squamous cell carcinoma component (>=10% of tumour ‡).

Note:

  • ‡ Criteria used by individual pathologists may vary and/or may not be uniformly applied.[3]

DDx:

Images

  • ASC - intermed. mag. (WC)

  • ASC - intermed. mag. (WC)

  • ASC - high mag. (WC)

  • ASC - very high mag. (WC)

www

Sign out

Biopsy - possible adenosquamous carcinoma

Left Upper Lobe of Lung, Core Biopsy:
     - NONSMALL CELL CARCINOMA, FAVOUR ADENOCARCINOMA, CANNOT EXCLUDE ADENOSQUAMOUS CARCINOMA.

Comment:
The tumour stains as follow:
POSITIVE: TTF-1, CK5/6 (focal), p63, napsin A.
NEGATIVE: (none).

The positive staining (TTF-1 and napsin A versus CK5/6 and p63) appears to be in different tumour cells.  

The case was reviewed internally and there is agreement on the above interpretation.

Note:

  • Cases should not be signed as adenosquamous carcinoma on biopsy, due to the percentage requirements (>=10% for both components) - see microscopic section.

See also

References

  1. ↑ Song, Z.; Lin, B.; Shao, L.; Zhang, Y. (Sep 2013). "Therapeutic efficacy of gefitinib and erlotinib in patients with advanced lung adenosquamous carcinoma.". J Chin Med Assoc 76 (9): 481-5. doi:10.1016/j.jcma.2013.05.007. PMID 23769878.
  2. ↑ Iwanaga, K.; Sueoka-Aragane, N.; Nakamura, T.; Mori, D.; Kimura, S. (2012). "The long-term survival of a patient with adenosquamous lung carcinoma harboring EGFR-activating mutations who was treated with gefitinib.". Intern Med 51 (19): 2771-4. PMID 23037472.
  3. ↑ 3.0 3.1 Rao, N. (Jul 2014). "Adenosquamous carcinoma.". Semin Diagn Pathol 31 (4): 271-7. doi:10.1053/j.semdp.2014.06.004. PMID 25002356.
  4. ↑ Vassella E, Langsch S, Dettmer MS, Schlup C, Neuenschwander M, Frattini M, Gugger M, Schäfer SC (September 2015). "Molecular profiling of lung adenosquamous carcinoma: hybrid or genuine type?". Oncotarget 6 (27): 23905–16. doi:10.18632/oncotarget.4163. PMC 4695160. PMID 26068980. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695160/.
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