Pulmonary adenocarcinomas: classification and reporting.

摘要: Pulmonary adenocarcinoma is the most common, and diverse form of primary lung carcinoma. The histological complexity these tumours poses problems for pathologists. current WHO classification pulmonary does not adequately address a number clinically relevant, biological factors. accurate diagnosis on small biopsy specimens, accounting diagnoses this disease, challenged by absence tumour architecture in samples. Tumours showing pure bronchioloalveolar (BAC) pattern are now best regarded as adenocarcinoma-in-situ; yet invasive adenocarcinomas may also show elements with BAC pattern, dictating better prognosis but biologically necessarily in-situ disease. Multifocal BAC-pattern still considerable conceptual diagnostic problems. In papillary especially when micropapillary, confers poor reflected larger tumours. early predominantly (in-situ) identification invasion particularly difficult, minor degrees infiltration seem to degrade prognosis. It therefore be possible define minimally category adenocarcinoma. Consequently, there issues consider reporting type, depending nature specimen. rapid emergence chemotherapeutic agents histology-specific efficacy will increase need more specific Immunohistochemistry help suggest features non-specific immunohistochemical findings cancer. emerging clinical prognostic relevance complex strengthens argument favour including quantitative detail sub-types reports resected