Lung metastasis

From Libre Pathology
Jump to: navigation, search
Lung metastasis
Diagnosis in short

Lung metastasis (Ewing sarcoma). H&E stain.
LM DDx primary lung cancer (adenocarcinoma of the lung, squamous cell carcinoma of the lung, small cell carcinoma of the lung), pulmonary meningothelial-like nodule, carcinoid tumourlet, carcinoid lung tumour
IHC TTF-1 (-ve useful if non-squamous), CK20 (+ve suggestive colorectal carcinoma), CK7 (-ve useful if non-squamous), GATA3 (+ve suggestive UCC)
Gross lung nodules - typically multiple and peripheral
Site lung

Clinical history +/-history of malignancy
Prevalence relatively common
Radiology peripheral lung lesions, typically multiple
Prognosis usually poor
Clin. DDx lung primary, abscess, multiple benign lung tumours as may be seen in DIPNECH
Treatment dependent on primary site, occasionally surgical

Lung metastasis, also pulmonary metastasis and metastatic lung disease, is relatively common and generally carries a poor prognosis.

General

  • Relatively common.

Gross

  • Typically peripheral, multiple, well-circumscribed & white/tan masses.
  • May be diffuse without an obvious mass +/- septal thickening.

Microscopic

Features:

DDx:

Images

IHC

  • TTF-1 -ve/+ve.
  • CK20 +ve/-ve.
    • Positive in colorectal carcinoma - very useful.
    • Negative in lung primaries.
  • GATA3 +ve/-ve.
  • CK7 -ve/+ve.
    • Positive in lung adenocarcinoma and small carcinoma of the lung.
    • Positive in a number of other tumours - breast, upper GI tract, thyroid, mesothelioma, salivary gland.
    • Negative in poorly differentiated carcinoma of the lung and squamous carcinoma of the lung.

See also

References

  1. Kfoury, H.; Arafah, MA.; Arafah, MM.; Alnassar, S.; Hajjar, W. (Feb 2012). "Mimicry of Minute Pulmonary Meningothelial-like Nodules to Metastatic Deposits in a Patient with Infiltrating Lobular Carcinoma: A Case Report and Review of the Literature.". Korean J Pathol 46 (1): 87-91. doi:10.4132/KoreanJPathol.2012.46.1.87. PMID 23109985.
  2. Chang, A.; Amin, A.; Gabrielson, E.; Illei, P.; Roden, RB.; Sharma, R.; Epstein, JI. (Oct 2012). "Utility of GATA3 immunohistochemistry in differentiating urothelial carcinoma from prostate adenocarcinoma and squamous cell carcinomas of the uterine cervix, anus, and lung.". Am J Surg Pathol 36 (10): 1472-6. doi:10.1097/PAS.0b013e318260cde7. PMID 22982890.