Lung adenocarcinoma with a micropapillary pattern: a clinicopathological study of 25 cases

• Published in: APMIS : acta pathologica, microbiologica et immunologica Scandinavica Vol. 114; no. 5; pp. 381 - 385
• Main Authors: KURODA, N., HAMAGUCHI, N., TAKEUCHI, E., OHARA, M., HIROUCHI, T., MIZUNO, K.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2006; Blackwell
• Subjects: Adenocarcinoma - pathology; Adenocarcinoma, Bronchiolo-Alveolar - pathology; Adenocarcinoma, Papillary - pathology; Aged; Aged, 80 and over; alveolar type; Biological and medical sciences; breast type; Calcinosis - pathology; Carcinoma, Acinar Cell - pathology; Female; Fundamental and applied biological sciences. Psychology; Humans; Infectious diseases; lung; Lung Neoplasms - pathology; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Medical sciences; Microbiology; Micropapillary adenocarcinoma; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Pleura - pathology; Survival Analysis; Tumors; Adenocarcinoma; Case study; Immunology; Microbiology; Lung; alveolar type; Micropapillary adenocarcinoma; breast type; Malignant tumor; Respiratory system
• ISSN: 0903-4641; 1600-0463
• DOI: 10.1111/j.1600-0463.2006.apm_340.x

Lung adenocarcinoma with a micropapillary pattern has recently been described, but its biological behavior is as yet uncertain. In this article we present a clinicopathological study of lung adenocarcinoma with micropapillary morphology. We selected 25 patients with lung adenocarcinoma with micropapillary morphology from the 2001–2004 pathology files (age range 54 to 81 years; mean 64.5 years). Micropapillary carcinoma is predominantly located at the periphery of the tumor nodule or mass and occurs irrespective of the subtype of the adenocarcinoma. A micropapillary component was seen against a mucinous background in three cases and microcalcifications resembling psammoma bodies were seen in one case. Four cases showed intensive invasive growth such as micropapillary adenocarcinoma of the breast and 21 showed alveolar type morphology with piling‐up of the neoplastic cells with or without stromal invasion. Seven of twenty‐three (30.4%) showed lymph node metastases at time of operation. Twelve of twenty‐five (48%) showed pleural invasion. Regarding clinical outcome, 14 patients were alive without disease, 5 were alive with disease, and 5 died of the lung adenocarcinoma. No significant relationship was found between the extent of the micropapillary component and prognosis. However, the carcinoma seen in the five patients who died showed breast type histology with intensive invasive growth in three cases and alveolar type histology with intensive stromal invasion in two. Lung micropapillary carcinoma of breast type may behave more aggressively than the alveolar type.