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pulmonary mucinous adenocarcinoma

Tuesday 13 September 2011

mucin-producing adencarcinomas; mucinous "colloid" adenocarcinoma, mucinous cystadenocarcinoma, and signet ring adenocarcinoma; mucinous adenocarcinomas of non-BAC type

Definition: Mucin may be a prominent finding in rare examples of non-bronchioloalveolar lung carcinomas.

Images

- Wikimedia: Mucinous lung adenocarcinoma

- Invasive mucinous adenocarcinoma Case 115 at YRC

Digital cases

- JRC:1597 : Cystic mucinous adenocarcinoma.
- JRC:6232 : pulmonary mucinous adenocarcinoma.

Reported cases vary in aggressiveness from low grade tumors of uncertain malignant potential to high grade adenocarcinomas with signet ring cells.

Of particular interest is a group of mucinous cystic tumors designated by a confusing array of terms analogous to those used for similar tumors occurring in non-pulmonary sites (eg, mucinous cystadenoma, mucinous cystic tumor of borderline malignancy, mucinous ["colloid"] carcinoma).

Most of these tumors present as asymptomatic, solitary, peripherally situated cystic masses.

Synopsis

- Rare as a subtype but mixed tumors frequently show mucinous morphology
- Appears same as in other organs in which it is more frequently encountered: dissecting mucin pools containing islands and strips of mucinous epithelium with malignant cytologic features
- In the lung, mucinous columnar cells can focally line alveoli in a lepidic pattern.
- The neoplastic goblet cells express enteric markers (CDX2, MUC2 and CK20) with inconsistent, focal and weak CK7 and TTF-1 expression—thus, clinical correlation is needed to diagnose this as a pure lung primary.
- Primary lung mucinous BAC does not show mucin pools invading stroma, is primarily composed of neoplastic mucinous cells lining alveolar walls, and does not show expression of CDX2 or MUC2.
- This neoplasm should be considered a low-grade carcinoma with more favorable survival rates compared to mucinous BAC or conventional mixed adenocarcinoma.

See also

- pulmonary carcinomas

  • pulmonary adenocarcinomas

Open references

- Size of Non-lepidic Invasive Pattern Predicts Recurrence in Pulmonary Mucinous Adenocarcinoma: Morphologic Analysis of 188 Resected Cases with Reappraisal of Invasion Criteria. Hwang S, Han J, Choi M, Ahn MJ, Choi YS.
J Pathol Transl Med. 2017 Jan;51(1):56-68. doi : 10.4132/jptm.2016.09.17
PMID: 27744658