Deciphering Lung Adenocarcinoma Heterogeneity: An Overview of Pathological and Clinical Features of Rare Subtypes

Abstract

Lung cancer is one of the most frequently diagnosed cancers worldwide and the leading cause of cancer-related death. The 2021 World Health Organization (WHO) classification provided a detailed and updated categorization of lung adenocarcinomas with a special focus on rare histological types, including enteric, fetal and colloid types, as well as not otherwise specified adenocarcinoma, overall accounting for about 5–10% of all cases. However, rare entities are nowadays difficult to diagnose in most centers, and evidence of optimal therapeutic management for these patients is still lacking. In recent years, increasing knowledge about the mutational profile of lung cancer, in addition to the spreading diffusion of next-generation sequencing (NGS) in different centers, have been helpful in the identification of rare variants of lung cancer. Hence, the hope is that several new drugs will be available in the near future to treat these rare lung tumors, such as in targeted therapy and immunotherapy, which are often used in clinical practice for several malignancies. The aim of this review is to summarize the current knowledge about the molecular pathology and clinical management of the most common rare adenocarcinoma subtypes in order to provide a concise and updated report that can drive clinicians’ choices in their routine practice.

Correlation between Radiological Characteristics, PET-CT and Histological Subtypes of Primary Lung Adenocarcinoma–A 102 Case Series Analysis

“…Then the histopathological type of tumor is obtained by bronchoscopy, tru-cut or FNA biopsy and the sample is significantly smaller in volume and the correlation with the morphological characteristics on CT is of great importance for making a final diagnosis. Findings on larger studies as also in our group of patients go for CT and PET-CT characteristics of histological subtypes [13][14][15][16][17][18][19] And for PET -Given the increase in the number of patients from year to year as well as the beginning of screening for this disease in some countries for risk groups, it is necessary to work as much as possible in this area to see a be er radiological picture and contribute to the correlation between different morphological features on CT with pathological, immune, genetic characteristics as well as the characteristics that the tumor shows on other imaging methods, all with the aim of be er understanding this disease. An example can be the proof that in the first stage of the disease, as well as in patients with AIS and MIA, the five-year survival is almost 100% [6,14,19 -23].…”

Correlation between Radiological Characteristics, PET-CT and Histological Subtypes of Primary Lung Adenocarcinoma—A 102 Case Series Analysis

“…Most findings on larger studies as well as in our group of patients go for CT and PET-CT characteristics of histological subtypes [13][14][15][16][17][18][19]:…”

“…And for PET, given the increase in the number of patients from year to year, as well as the beginning of screening for this disease in some countries for risk groups, it is necessary to work in this area as much as possible to see a better radiological picture and contribute to the correlation between different morphological features on CT with pathological, immune, and genetic characteristics, as well as the characteristics that the tumor shows on other imaging methods, all with the aim of better understanding this disease. An example can be the proof that in the first stage of the disease, as well as in patients with AIS and MIA, the five-year survival is almost 100% [6,14,[19][20][21][22][23]. There were no other major studies that show gender correlation, and based on our experience, there is no predilection for any gender to develop any subtype of adenocarcinoma, so basic gender results in this paper are the consequence of a relatively small sample [24][25][26].…”