Cribriform adenocarcinoma of lung:a clinicopathological analysis of twenty cases / 临床与实验病理学杂志

ABSTRACT

Purpose To investigate the clinicopathological features,diagnosis and differential diagnosis,and genetic alteration of lung cribriform adenocarcinoma (LCA).Methods Clinicopathological features and immunophenotype were retrospectively evaluated in twenty LCA cases collected from Fujian Provincial Hospital,combined with genetic mutation analysis of EGFR.Results The tumors occurred in 5 women and 15 men aged from 39 to 74 years (median =59.25).Diameter of masses ranged from 1.5-5.5 cm (median =3.265).Histologically,the tumors were unencapsulated and were divided by fibrous septa into lobules.Major parts of the lesions were composed of areas with solid and microcystic growth patterns.The most striking cytological feature was that the tumor cell nuclei were pale staining with a ground glass feature,and they often appeared to overlap.Immunephenotypically,the tumor cells were positive for TTF-1(20/20),Napsin A (18/20),SPB(19/20),CK7(20/20),CD56 (2/20),EGFR (7/20),β-catenin (4/20),ALK (2/20).Tg,CDX-2,Syn,CgA,S-100 and SMA were negative.Gene mutation detection confirmed that EGFR genes were mutating in nine cases,and eleven cases were wild type.The twenty cases were all performed for the completely surgical resection.20 cases accepted chemotherapy,and 4 cases unaccepted chemotherapy.Conclusion LCA is a rare tumor with distinct morphologic feature.Clinically and pathologically,it needs to differentiate from alveolus adenocarcinoma,adenoid cystic carcinoma and papillary carcinoma of the thyroid,and so on.The primary treatment for LCA is completely surgical excision and chemotherapy.Otherwise its prognosis is poor.