Papillary-predominant adenocarcinoma of the lung

Changed by Bruno Di Muzio, 16 Dec 2018

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Papillary predominant-predominant adenocarcinoma of the lung
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Papillary predominant-predominant adenocarcinoma of the lung is a histological subtype of non-mucinous invasive adenocarcinoma of the lung.

Terminology

In 2011, the International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS), and European Respiratory Society (ERS) 5 introduced a new classification and terminology for adenocarcinoma of the lung, which is now divided into 'preinvasive', 'minimally invasive', and 'invasive'. 

The term bronchoalveolar carcinoma (BAC) has been retired, and it is recommended that all invasive adenocarcinomas be classified in terms of the "predominant" comprising histology 5. Both mucinous and non-mucinous adenocarcinomas typically consist of a mixture of histologic patterns, but reporting of the predominant subtype (lepidic, acinar, papillary, micropapillary, or solid growth) is specifically recommended for non-mucinous lesions, with all mucinous tumours placed in a separate category.

Epidemiology

It may account for 7-12% of all lung adenocarcinomas. There may be predilection in female non-smokers 1.

Pathology

It this form papillary structures replace the underlying alveolar architecture. True papillary adenocarcinoma is usually diagnosed when the pathological features constitute >75% of the tumour on histopathology.

Radiographic features

CT 

Variable appearances have been described ranging from a solitary pulmonary nodule, as a mass containing internal bubble lucencies with surrounding ground-glass opacity and satellite micronodules or as a triangular mass with satellite micronodules 2.

Treatment and prognosis

The presence of a micropapillary component in papillary carcinoma has been associated with early lymph node metastasis, intrapulmonary metastasis and a significantly lower 5-year survival rate 1.

  • -<p><strong>Papillary predominant adenocarcinoma of the lung</strong> is a subtype of <a href="/articles/adenocarcinoma-of-the-lung">adenocarcinoma of the lung</a>.</p><h4>Epidemiology</h4><p>It may account for 7-12% of all lung adenocarcinomas. There may be predilection in female non-smokers<sup> 1</sup>.</p><h4>Pathology</h4><p>It this form papillary structures replace the underlying alveolar architecture. True papillary adenocarcinoma is usually diagnosed when the pathological features constitute &gt;75% of the tumour on histopathology.</p><h4>Radiographic features</h4><h5>CT </h5><p>Variable appearances have been described ranging from a solitary pulmonary nodule, as a mass containing internal bubble lucencies with surrounding ground-glass opacity and satellite micronodules or as a triangular mass with satellite micronodules <sup>2</sup>.</p><h4>Treatment and prognosis</h4><p>The presence of a micropapillary component in papillary carcinoma has been associated with early lymph node metastasis, intrapulmonary metastasis and a significantly lower 5-year survival rate<sup> 1</sup>.</p>
  • +<p><strong>Papillary-predominant adenocarcinoma of the lung</strong> is a histological subtype of non-mucinous invasive <a href="/articles/adenocarcinoma-of-the-lung">adenocarcinoma of the lung</a>.</p><h4>Terminology</h4><p>In 2011, the International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS), and European Respiratory Society (ERS) <sup>5</sup> introduced a new classification and terminology for adenocarcinoma of the lung, which is now divided into 'preinvasive', 'minimally invasive', and 'invasive'. </p><p>The term <a href="/articles/adenocarcinoma-in-situ-minimally-invasive-adenocarcinoma-and-invasive-adenocarcinoma-of-lung">bronchoalveolar carcinoma (BAC)</a> has been retired, and it is recommended that all invasive adenocarcinomas be classified in terms of the "predominant" comprising histology <sup>5</sup>. Both mucinous and non-mucinous adenocarcinomas typically consist of a mixture of histologic patterns, but reporting of the predominant subtype (lepidic, acinar, papillary, micropapillary, or solid growth) is specifically recommended for non-mucinous lesions, with all <a href="/articles/invasive-mucinous-adenocarcinoma-of-the-lung-1">mucinous tumours</a> placed in a separate category.</p><h4>Epidemiology</h4><p>It may account for 7-12% of all lung adenocarcinomas. There may be predilection in female non-smokers<sup> 1</sup>.</p><h4>Pathology</h4><p>It this form papillary structures replace the underlying alveolar architecture. True papillary adenocarcinoma is usually diagnosed when the pathological features constitute &gt;75% of the tumour on histopathology.</p><h4>Radiographic features</h4><h5>CT </h5><p>Variable appearances have been described ranging from a solitary pulmonary nodule, as a mass containing internal bubble lucencies with surrounding ground-glass opacity and satellite micronodules or as a triangular mass with satellite micronodules <sup>2</sup>.</p><h4>Treatment and prognosis</h4><p>The presence of a micropapillary component in papillary carcinoma has been associated with early lymph node metastasis, intrapulmonary metastasis and a significantly lower 5-year survival rate<sup> 1</sup>.</p>

References changed:

  • 5. Travis WD, Brambilla E, Noguchi M et-al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6 (2): 244-85. <a href="http://dx.doi.org/10.1097/JTO.0b013e318206a221">doi:10.1097/JTO.0b013e318206a221</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/21252716">Pubmed citation</a><span class="ref_v3"></span>

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