Pseudosquamous Adenocarcinoma of the Lung

病理 腺癌 细胞质 合并(版本控制) 基底细胞 医学 细胞 粉刺 生物 癌症 内科学 生物化学 遗传学 情报检索 乳腺癌 计算机科学 导管癌
作者
David Suster,Natali Ronen,Saul Suster
出处
期刊:The American Journal of Surgical Pathology [Lippincott Williams & Wilkins]
卷期号:48 (7): 901-908
标识
DOI:10.1097/pas.0000000000002242
摘要

Pseudosquamous adenocarcinoma of the lung is an unusual morphologic variant of poorly differentiated non–small cell lung carcinoma that superficially resembles a squamous cell carcinoma. We have examined 10 cases of these tumors in 4 women and 6 men, aged 47 to 93 years. The tumors were all peripheral and measured from 1.5 to 5.5 cm. All cases were characterized by solid nests of large polygonal tumor cells containing atypical nuclei with abundant cytoplasm and sharp cell borders, adopting a pavement-like architecture that simulated squamous cell carcinoma. Some cases demonstrated intracytoplasmic hyaline inclusions suggestive of keratinization. The nests of tumor cells often showed central comedo-like areas of necrosis. Intercellular bridges were not seen in any of the cases. The tumors often displayed marked clearing of the cytoplasm enhancing their epidermoid appearance. In 4 cases, the solid pseudosquamous areas were seen to merge with a focal lepidic adenocarcinoma component, and in 1 case, abortive microscopic foci of acinar differentiation were also noted within the tumor. One case showed focal sarcomatoid spindle cell areas. The tumor cells were negative for p40 and CK5/6 and labeled with TTF1 or Napsin-A, confirming an adenocarcinoma phenotype. Clinical follow-up information was available in 8 patients; 6 patients died of their tumors between 6 months to 11 years after diagnosis (mean: 3.1 y). One patient died of complications related to surgery and one patient with a low-stage tumor died at 27 years from other causes. Solid pattern adenocarcinomas can be confused for squamous cell carcinoma and may require immunohistochemistry to determine their true phenotype.
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