Well‐differentiated fetal adenocarcinoma of the lung mimicking adenoid cystic carcinoma on fine needle aspiration: A case report

Rerkpichaisuth, Vilasinee; Collins, Jennifer A.; Boonyaarunnate, Thiraphon; Ali, Syed Z.

doi:10.1002/dc.23526

Cited by 3 publications

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References 23 publications

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“…Low‐grade fetal adenocarcinoma of the lung is a rare malignant lung cancer accounting for approximately 0.1% or less of all lung tumors 15 . An initial diagnosis of L‐FLAC occurs during the early stages (I–II) of the disease, 16 a finding which is consistent with our results.…”

Section: Discussionsupporting

confidence: 91%

Novel genetic characteristics in low‐grade fetal adenocarcinoma of the lung

et al. 2021

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Background Low‐grade fetal adenocarcinoma of the lung (L‐FLAC) is a rare subtype of lung adenocarcinoma with undetermined histological features and genetic abnormalities. In this study, we attempted to investigate the pathological characteristics and genomic profiles of L‐FLAC. Methods Among 9839 cases of primary lung adenocarcinoma resected at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2011 and June 2016, three cases diagnosed with L‐FLAC were selected. An immunohistochemical profile and whole exome sequencing (WES) using tumor and normal tissues was conducted. The last follow‐up date of patients was January 2021. Results Three cases diagnosed with L‐FLAC were finally screened, suggesting a percentage of 0.03%. All three patients were male and diagnosed as stage I following radical lobectomy. The missense variant was found to be the major gene mutation type using WES. CTNNB1 and DICER1 were the two most frequent gene mutations. All cases demonstrated positive TTF‐1 expression. In addition, two patients showed positive expression of β‐catenin (nuclear/cytoplasmic expression), CgA and Sny. Negative expression of PD‐L1 in tumor cells was observed in all three cases. One case with a relatively high tumor mutation burden (TMB) (2.18 mut/Mb) had an inferior overall survival of 11.5 months. However, the other two cases with a lower TMB (0.12 and 0.74 mut/Mb) still acquired disease‐free status up to the last follow‐up date. Conclusions L‐FLAC has a specific molecular background which is different from lung adenocarcinoma. Furthermore, gene heterogeneity was found and might be the reason for a dramatically different prognosis in these L‐FLAC patients.

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Section: Discussionsupporting

confidence: 91%

Novel genetic characteristics in low‐grade fetal adenocarcinoma of the lung

et al. 2021

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Novel gene mutations in well-differentiated fetal adenocarcinoma of the lung in the next generation sequencing era

et al. 2018

Lung Cancer

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Co-existence of well-differentiated fetal adenocarcinoma of the lung with tuberculosis in a young female

Guo

Wang

et al. 2019

Medicine

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Rationale: Fetal adenocarcinoma of the lung (FLAC) with fetal lung-like morphology is a rare entity of pulmonary adenocarcinoma. Well-differentiated fetal adenocarcinoma (WDFA) belongs to its the low-grade form, which possesses a relatively favorable prognosis. Tuberculosis (TB) is an aggressive infectious disease that has been ranked as one of the top 10 causes of death worldwide. There may be a connection between the 2 and attention should be paid to the differential diagnosis. Patient concerns: A 28-year-old non-smoking female was admitted with signs of hemoptysis, and she had been coughing up phlegm for 5 years. The patient was previously diagnosed with TB in another hospital, and underwent an anti-TB regimen. Diagnosis: The co-existence of WDFA and TB was confirmed via histopathological evaluation of postoperative samples. Interventions: The patient was subjected to a right lower lobectomy together with a wedge resection of the right upper lobe using video-assisted thoracoscopic surgery, with systemic lymphadenectomy. Outcomes: The patient tolerated the surgical procedure well and underwent an uneventful postoperative course. Lessons: To our knowledge, no previous reports exist of cases with WDFA accompanied by TB. The present case indicated that a prior diagnosis of TB might predispose to lung cancer regardless of smoking history. It is also essential to distinguish WDFA from TB because of the similarity in clinical features and sites of pathological changes. Patients with WDFA usually have a better prognosis and surgery is the preferred treatment.

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Well‐differentiated fetal adenocarcinoma of the lung mimicking adenoid cystic carcinoma on fine needle aspiration: A case report

Cited by 3 publications

References 23 publications

Novel genetic characteristics in low‐grade fetal adenocarcinoma of the lung

Novel genetic characteristics in low‐grade fetal adenocarcinoma of the lung

Novel gene mutations in well-differentiated fetal adenocarcinoma of the lung in the next generation sequencing era

Co-existence of well-differentiated fetal adenocarcinoma of the lung with tuberculosis in a young female

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