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Difference between revisions of "Lung tumours"
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→Specific types: +CCST, re-order, subdivid
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**Central location (vis-a-vis peripheral location) tends favours ''typical carcinoid'' over ''atypical carcinoid''. | **Central location (vis-a-vis peripheral location) tends favours ''typical carcinoid'' over ''atypical carcinoid''. | ||
= | =Malignant tumours= | ||
==Lung adenocarcinoma== | ==Lung adenocarcinoma== | ||
===General=== | ===General=== | ||
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#*Subtypes: micropapillary, mucinous (previously ''mucinous BAC'', colloid, fetal, enteric. | #*Subtypes: micropapillary, mucinous (previously ''mucinous BAC'', colloid, fetal, enteric. | ||
== | ==Bronchioloalveolar carcinoma== | ||
* | *Abbreviated ''BAC''. | ||
The term is no longer used in the new classification.<ref name=pmid21926387>{{Cite journal | last1 = Travis | first1 = WD. | last2 = Brambilla | first2 = E. | last3 = Noguchi | first3 = M. | last4 = Nicholson | first4 = AG. | last5 = Geisinger | first5 = K. | last6 = Yatabe | first6 = Y. | last7 = Powell | first7 = CA. | last8 = Beer | first8 = D. | last9 = Riely | first9 = G. | title = International association for the study of lung cancer/American Thoracic Society/European Respiratory Society: international multidisciplinary classification of lung adenocarcinoma: executive summary. | journal = Proc Am Thorac Soc | volume = 8 | issue = 5 | pages = 381-5 | month = Sep | year = 2011 | doi = 10.1513/pats.201107-042ST | PMID = 21926387 |URL = http://iaslc.org/assets/Documents/lung-adenocarcinoma-classification.pdf }}</ref> | |||
*It is now "adenocarcinoma in situ" see ''[[lung adenocarcinoma]]''. | |||
*[[ | |||
==Malignant mesothelioma== | ==Malignant mesothelioma== | ||
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**Ber-EP4. | **Ber-EP4. | ||
**MOC-31. | **MOC-31. | ||
=Malignant potential= | |||
==Atypical carcinoid lung tumour== | |||
*[[AKA]] ''carcinoid tumour of the lung''. | |||
===General=== | |||
*Approximately 20% of lung carcinoids.<ref name=pmid20888248>{{Cite journal | last1 = Naalsund | first1 = A. | last2 = Rostad | first2 = H. | last3 = Strøm | first3 = EH. | last4 = Lund | first4 = MB. | last5 = Strand | first5 = TE. | title = Carcinoid lung tumors--incidence, treatment and outcomes: a population-based study. | journal = Eur J Cardiothorac Surg | volume = 39 | issue = 4 | pages = 565-9 | month = Apr | year = 2011 | doi = 10.1016/j.ejcts.2010.08.036 | PMID = 20888248 }}</ref> | |||
===Microscopic=== | |||
Features: | |||
*Nests of cells. | |||
**Stippled chromatin. | |||
**Mild-to-moderate amount of cytoplasm. | |||
*No necrosis. | |||
*Moderate mitotic rate. | |||
DDx: | |||
*[[Typical carcinoid lung tumour]]. | |||
*[[Small cell carcinoma of the lung]]. | |||
===IHC=== | |||
*MIB-1 moderate staining. | |||
==Solitary fibrous tumour of the pleura== | ==Solitary fibrous tumour of the pleura== | ||
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*CD34 +ve. | *CD34 +ve. | ||
== | =Benign tumours= | ||
*Abbreviated '' | ==Pulmonary carcinoid tumourlet== | ||
*[[AKA]] ''carcinoid tumourlet''. | |||
===General=== | |||
*Neuroendocrine cell proliferation.<ref>{{Cite journal | last1 = Bennett | first1 = GL. | last2 = Chew | first2 = FS. | title = Pulmonary carcinoid tumorlets. | journal = AJR Am J Roentgenol | volume = 162 | issue = 3 | pages = 568 | month = Mar | year = 1994 | doi = | PMID = 8109497 | URL = http://www.ajronline.org/content/162/3/568.full.pdf }}</ref> | |||
**Essentially a small [[typical carcinoid lung tumour|typical carcinoid]]. | |||
===Microscopic=== | |||
Features: | |||
*Nests of cells - classic pattern. | |||
**Salt and pepper chromatin - '''key feature'''. | |||
*Size criterion: <= 4 mm.<ref name=pct_ucsf>URL: [http://pathhsw5m54.ucsf.edu/case7/image75.html http://pathhsw5m54.ucsf.edu/case7/image75.html]. Accessed on: 23 January 2012.</ref> | |||
DDx: | |||
*[[Typical carcinoid lung tumour]]. | |||
Images: | |||
*[http://pathhsw5m54.ucsf.edu/case7/image75.html Tumourlets - several images (ucsf.edu)]. | |||
==Typical carcinoid lung tumour== | |||
*[[AKA]] ''carcinoid tumour of the lung''. | |||
===General=== | |||
*Approximately 80% of lung carcinoids.<ref name=pmid20888248>{{Cite journal | last1 = Naalsund | first1 = A. | last2 = Rostad | first2 = H. | last3 = Strøm | first3 = EH. | last4 = Lund | first4 = MB. | last5 = Strand | first5 = TE. | title = Carcinoid lung tumors--incidence, treatment and outcomes: a population-based study. | journal = Eur J Cardiothorac Surg | volume = 39 | issue = 4 | pages = 565-9 | month = Apr | year = 2011 | doi = 10.1016/j.ejcts.2010.08.036 | PMID = 20888248 }}</ref> | |||
===Microscopic=== | |||
Features: | |||
*Nests of cells. | |||
**Stippled chromatin. | |||
**Moderate cytoplasm. | |||
*No necrosis. | |||
*Low mitotic rate. | |||
*Size criterion: > 4 mm.<ref name=pct_ucsf>URL: [http://pathhsw5m54.ucsf.edu/case7/image75.html http://pathhsw5m54.ucsf.edu/case7/image75.html]. Accessed on: 23 January 2012.</ref> | |||
DDx: | |||
*[[Pulmonary carcinoid tumourlet]]. | |||
*[[Atypical carcinoid lung tumour]]. | |||
===IHC=== | |||
*MIB-1 scant staining. | |||
==Clear cell sugar tumour of the lung== | |||
*[[AKA]] ''clear cell sugar tumour''. | |||
**Abbreviated ''CCST''. | |||
===General=== | |||
*A [[PEComa]]. | |||
===Microscopic=== | |||
Features: | |||
*Cells with clear cytoplasm. | |||
Images: | |||
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=20080802170404452 Clear cell sugar tumour of the lung (surgicalpathologyatlas.com)]. | |||
=See also= | =See also= | ||