Micropapillary adenocarcinoma of lung: Morphological criteria and diagnostic reproducibility among pulmonary pathologists

Monroig-Bosque, Paloma del C.; Morales‐Rosado, Joel A.; Roden, Anja C.; Churg, Andrew; Barrios, Roberto; Cagle, Philip T.; Ge, Yimin; Allen, Timothy Craig; Smith, Maxwell L.; Larsen, Brandon T.; Sholl, Lynette M.; Beasley, Mary Beth; Raparia, Kirtee; Ayala, Alberto G.; Tazelaar, Henry D.; Miller, Ross A.; Kalhor, Neda; Moran, César A.; Ro, Jae Y.

doi:10.1016/j.anndiagpath.2019.04.008

Cited by 10 publications

(10 citation statements)

References 35 publications

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“…As group A, group C includes TRU‐type LADCs that predominantly affect female nonsmokers. This type has a micropapillary element in lepidic or papillary backgrounds, where proportions of the micropapillary element vary among cases, but generally are not so large (typically 5 to 25%) in surgically removed LADCs 13,14 . LADCs of this group are usually described as “lepidic or papillary‐dominant LADC with micropapillary element” or simply as “lepidic or papillary‐dominant LADC” or “minimally invasive adenocarcinoma” in pathological diagnosis reports, and they comprise 13.8% of surgically removed LADCs (Table 1).…”

Section: A Proposal Of Five Essential Groups For Ladcsmentioning

confidence: 99%

“…To form such structures, neoplastic cells are inevitably anchorage independent, detach from basement membranes, can grow, and simultaneously have to retain epithelial polarity and an intercellular adhesion system partially 13,23‐26 . It is essential to question how lepidic (or papillary) elements acquire the micropapillary phenotype in terms of their molecular basis 14,23‐25,27 . p53 mutations can be an important factor to trigger this process, 28‐30 but there also seem to be additional unique events.…”

Section: Tumor Progression In the Nonsmokers’ Pathwaymentioning

confidence: 99%

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The nonsmokers’ and smokers’ pathways in lung adenocarcinoma: Histological progression and molecular bases

Okihara

Matsumura

Arai³

et al. 2021

Cancer Science

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There could be two carcinogenetic pathways for lung adenocarcinoma (LADC): the nonsmokers’ pathway and the smokers’ pathway. This review article describes the two pathways with special reference to potential relationships between histological subtypes, malignant grades, and driver mutations. The lung is composed of two different tissue units, the terminal respiratory unit (TRU) and the central airway compartment (CAC). In the nonsmokers’ pathway, LADCs develop from the TRU, and their histological appearances change from lepidic to micropapillary during the progression process. In the smokers’ pathway, LADCs develop from either the TRU or the CAC, and their histological appearances vary among cases in the middle of the progression process, but they are likely converged to acinar/solid at the end. On a molecular genetic level, the nonsmokers’ pathway is mostly driven by EGFR mutations, whereas in the smokers’ pathway, approximately one‐quarter of LADCs have KRAS mutations, but the other three‐quarters have no known driver mutations. p53 mutations are an important factor triggering the progression of both pathways, with unique molecular alterations associated with each, such as MUC21 expression and chromosome 12p13‐21 amplification in the nonsmokers’ pathway, and HNF4α expression and TTF1 mutations in the smokers’ pathway. However, investigation into the relationship between histological progression and genetic alterations is in its infancy. Tight cooperation between traditional histopathological examinations and recent molecular genetics can provide valuable insight to better understand the nature of LADCs.

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Section: A Proposal Of Five Essential Groups For Ladcsmentioning

confidence: 99%

Section: Tumor Progression In the Nonsmokers’ Pathwaymentioning

confidence: 99%

The nonsmokers’ and smokers’ pathways in lung adenocarcinoma: Histological progression and molecular bases

Okihara

Matsumura

Arai³

et al. 2021

Cancer Science

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“…Mikropapiler merupakan subtipe yang ukuran selnya kecil dan berbentuk kuboid, pola pertumbuhannya mikropapiler, dan terdapat fibrovascular core meskipun jarang. 27 Hasil penelitian Monroig-Bosque et al 13 menunjukkan bahwa adenokarsinoma mikropapiler juga terdapat sel-sel kolumnar, sarang sel tipis memanjang, retraksi stroma yang luas, pembentukan lumen dengan berkas epitel internal, bentuk epitel seperti signet ring, vakuolisasi intra-sitoplasma, banyak sarang di ruang alveolar yang sama, ruang lakunar back-to-back, anastomosis epitel, pleomorfisme yang ditandai, inti yang berorientasi perifer, dan inti yang menyebar secara acak. 13 Subtipe solid terdiri atas sel tumor dengan bentuk poligonal membentuk lembaran yang tidak dikenali, terdapat musin intrasel dengan minimal lima sel tumor pada lapangan pandang kecil, sitoplasma sel jernih dengan inti yang sangat pleomorfik, dan memiliki prognosis yang buruk.…”

Section: Bahasan Morfologi Kanker Paru Tipe Adenokarsinomaunclassified

Morfologi, Patogenesis, dan Imunoterapi Kanker Paru Tipe Adenokarsinoma

Robot

Durry

Kairupan

2021

MSJ

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Although some common therapies for cancers are available, many patients experience relapse during therapy. Therefore, an understanding of the pathogenesis of lung adenocarcinomas is needed in lung cancer therapies, especially targeted therapies. Immunotherapy has been shown to be effective in the therapy of various tumors, including non-small cell lung cancer (NSCLC). This study was aimed to review the morphology, pathogenesis, and immunotherapy of lung adenocarcinomas. This was a literature review study using databases of Clinical Key, Pubmed, and Google Scholar. The results showed that morphology of lung adenocarcinomas was characterized by the presence of lesions consisting of several morphological spectra, starting with pre-invasive lesions, then minimally invasive adenocarcinomas to invasive adenocarcinomas. Pathogenesis of lung adenocarcinomas was associated with genetic changes of several genes such as EGFR, KRAS, ALK, and ROS1; however, the most frequently involved were EGFR, KRAS, and ALK. The immunotherapies used for lung adeno-carcinomas were nivolumab, pembrolizumab, atezolizumab, tremelimumab, durvalumab, avelumab, cemiplimab, cetuximab, panitumumab, and matuzumab; however, the most commonly used were nivolumab, pembrolizumab, and atezolizumab. In conclusion, morphological spectra of lung adeno-carcinomas are pre-invasive lesions, minimally invasive adenocarcinomas, and invasive adeno-carcinomas. Pathogenesis of lung adenocarcinomas is associated with the presence of genetic changes, especially mutations of EGFR, KRAS and ALK. The most widely used immunotherapies for lung adenocarcinomas are nivolumab and pembrolizumab, which are included in the PD-1 antibody group and atezolizumab in the PD-L1 antibody group.Keywords: lung adenocarcinoma morphology; pathogenesis; immunotherapy Abstrak: Telah tersedia beberapa terapi umum kanker namun banyak pasien mengalami kekambuhan saat terapi. Oleh karena itu dibutuhkan pemahaman tentang patogenesis adenokarsinoma paru dalam terapi kanker paru khususnya terapi target. Imunoterapi dianggap sebagai teknologi yang memberikan harapan dan telah terbukti efektif dalam terapi berbagai tumor, termasuk non-small cell lung cancer (NSCLC). Penelitian ini bertujuan untuk menelaah morfologi, patogenesis, dan imunoterapi dari kanker paru tipe adenokarsinoma. Jenis penelitian ialah literature review menggunakan database Clinical Key, Pubmed, dan Google Scholar. Hasil penelitian mendapatkan morfologi adenokarsinoma paru ditandai adanya lesi yang terdiri dari beberapa spektrum morfologik, diawali dengan lesi preinvasif, selanjutnya lesi adenokarsinoma invasif minimal sampai adenokarsinoma invasif. Patogenesis adenokarsinoma paru berhubungan dengan perubahan genetik beberapa gen, yaitu EGFR, KRAS, ALK, dan ROS1; namun yang paling sering terlibat ialah EGFR, KRAS, dan ALK Imunoterapi yang digunakan untuk terapi adenokarsinoma paru ialah nivolumab, pembrolizumab, atezolizumab, tremelimumab, durvalumab, avelumab, cemiplimab, cetuximab, panitumumab, dan matuzumab; namun terbanyak digunakan ialah nivolumab, pembrolizumab, dan atezolizumab. Simpulan penelitian ini ialah spektrum morfologi dari adenokarsinoma paru berupa lesi preinvasif, adenokarsinoma invasif minimal, dan adenokarsinoma invasif. Patogenesis dari adenokarsinoma paru berhubungan dengan adanya perubahan genetik, terutama mutasi EGFR, KRAS, dan ALK. Imunoterapi yang paling banyak digunakan untuk terapi adenokarsinoma paru ialah nivolumab dan pembrolizumab yang termasuk dalam golongan antibodi PD-1 serta atezolizumab yang masuk dalam golongan antibodi PD-L1.Kata kunci: morfologi adenokarsinoma paru; patogenesis; imunoterapi

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“…Thus, while 5 or more clusters of STAS may be relevant in terms of survival, the significance of a few (2-4) clusters of STAS remains uncertain. As for the reproducibility of STAS among pathologists, in the study by Monroig-Bosque and colleagues, the diagnosis of STAS in 30 adenocarcinomas with significant micropapillary pattern varied from 34.1% to 52.8% (mean 43.4%) among 15 pulmonary pathologists (25). Further large-scale studies are warranted to elucidate and improve the reproducibility of the STAS diagnosis by pathologists.…”

Section: Editorial Commentarymentioning

confidence: 99%

Lung neuroendocrine tumors: a new addition to the evolving list of spread through air spaces

Uruga

Mino‐Kenudson

2019

Transl Lung Cancer Res

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Micropapillary adenocarcinoma of lung: Morphological criteria and diagnostic reproducibility among pulmonary pathologists

Cited by 10 publications

References 35 publications

The nonsmokers’ and smokers’ pathways in lung adenocarcinoma: Histological progression and molecular bases

The nonsmokers’ and smokers’ pathways in lung adenocarcinoma: Histological progression and molecular bases

Morfologi, Patogenesis, dan Imunoterapi Kanker Paru Tipe Adenokarsinoma

Lung neuroendocrine tumors: a new addition to the evolving list of spread through air spaces

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