Adenosquamous carcinoma of the lung

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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]

  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:

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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.