acinar adenocarcinoma lung pathology outlines

(Fig. STAS. adenocarcinoma lung pathology outlines … Invasive adenocarcinoma of lung, acinar type. 2013) A pure mucinous histologic pattern without non-mucinous elements is associated with lower stage and better prognosis than mixed tumors. All rights reserved. A total of 30 cases were included, representing 9% of all resections of pulmonary adenocarcinomas from 2003 to 2014. The 2015 World Health Organization (WHO) lung adenocarcinoma classification divides tumours into categories of indolent pre-invasive, minimally invasive and predominantly lepidic and, by examining predominant patterns of invasion, allows for further stratification into intermediate and high-grade tumours. Some partners do not ask for your consent to process your data, instead, they rely on their legitimate business interest. The medical term “acinar adenocarcinoma” is derived from both Latin and Greek languages: the word “acinar” originates from a Latin word acinus that means “berry,” while “adenocarcinoma” is a combination of the words adeno and carcinoma, both of which mean “gland” and “cancer,” respectively. Careers. Righi L, Vatrano S, Di Nicolantonio F, Massa F, Rossi G, Cavazza A, Volante M, Votta A, Izzo S, Lo Iacono M, Ardissone F, Di Maio M, Novello S, Scagliotti GV, Papotti M (2016) Retrospective multicenter study investigating the role of targeted next-generation sequencing of selected Cancer genes in mucinous adenocarcinoma of the lung. Reproducibility of the model was assessed using kappa statistics. Patterns of tumor growth. However, variations and mixed patterns are frequent in adenocarcinoma, and a strong correlation between mucinous and nonmucinous cells and TTF1 staining patterns has not been established in mucinous adenocarcinomas. pure lepidic growth (outlines alveoli) lacks invasion (stromal, vascular, pleural) lacks invasive patterns (acinar, papillary, solid, micropapillary) lacks spread through airspace: no intraalveolar cells; mostly nonmucinous (type II pneumocytes or clara cells), rarely mucinous; minimal atypia; septal widening with sclerosis/elastosis is common slide 34 of 128: Tweets by @WebPathology . (Kamata et al. Springer Nature. Info. The WHO classification currently views invasive mucinous adenocarcinoma as a “variant” and therefore not subject to pattern subclassification. 4). Contrary to the head and neck region, benign SGT such as pleomorphic adenomas are exceedingly rare in the pulmonary system. 2016) A mucinous variant of micropapillary carcinoma has also been described, which corresponds to mucinous carcinomas in the current study with micropapillary STAS. Epub 2015 Oct 17. Mucinous adenocarcinoma is often considered a relatively poor prognostic group among adenocarcinomas of the lung and has a high rate of pulmonary recurrence. (Travis et al. The largest invasive component was divided in < 1, 1–2, and > 2 cm size categories. Columnar / goblet cell type was inversely correlated with TTF-1 expression (p = 0.01). Five tumors had colloid areas but other areas with lepidic spread typical of conventional mucinous adenocarcinomas. describe the spreading of tissue fragments and individual cells through a knife surface as one of the possible artifacts in lung specimens. Lung adenocarcinomas are histologically and clinically heterogeneous. Conclusions: 2014) A recent study including both small biopsies and surgical resections has found that ALK fusion protein is more frequently seen in invasive mucinous adenocarcinomas than in other adenocarcinomas. (Rossi et al. We retrospectively studied time to lung recurrence and time to distant … Predictive value of the international association for the study of lung cancer/American Thoracic Society/European Respiratory Society classification of lung adenocarcinoma in tumor recurrence and patient survival. Acinar adenocarcinoma is the cause of roughly 90% of prostate cancer cases. The presence of STAS was classified as any tumor nests, islands, tubules, micropapillary tufts, or single cells floating freely within alveolar spaces outside and distant from the egde of the tumor not attached to the alveolar walls (Fig. 2004) Although historically the term “colloid” has been used interchangeably with “mucinous”, the most recent WHO classification considers colloid carcinomas as a separate variant of adenocarcinoma, specifically defined by inconspicuous lepidic growth and airspaces distended with mucus containing tumor nests. 2014 Aug 1;32(22):2357-64. doi: 10.1200/JCO.2013.50.1049. 2016). A cohort of 284 stage I pulmonary adenocarcinomas was used as a training set to identify histologic features associated with patient outcomes (recurrence-free survival [RFS] and overall survival [OS]). Pathology and Genetics of Tumors of the lung, Pleura, Thymus and heart. Google Scholar, Jessurun J (2015) Intra-alveolar intestinal epithelium: a reappraisal of the so-called mucinous goblet-cell rich carcinoma apropos of two cases with prolonged follow-up and literature review. (Kadota et al. 2006; Wu et al. It is a type of non-small cell lung cancer that usually develops in the peripheral region of the lungs (peripheral airways) Lepidic Adenocarcinoma of Lung is a histological subtype of pulmonary adenocarcinoma. More recently, 2 additional SGT, namely hyalinizing clear cell carcinoma and salivary duct-like carcinoma were recognized as primary lung tumors expanding the … Tumors with 0 or < 20% solid or solid cribriform growth were considered group 1; tumors with 20% or more solid or solid cribriform growth were considered group 2. Censors were set for two times points with statistics run independently: time to distant recurrence; and time to lung recurrence. 3Department of Pathology, Hachioji Medical Center of Tokyo Medical University, Japan Abstract Background and objective: The 4th edition of the WHO Classification of Tumors of the Lung, Pleura, Thymus and Heart states that adenocarcinomas should be classified according to the predominant pattern. 2014; Qu et al. The major changes in the 2015 WHO classification of adenocarcinomas of the lung (resected tumors) are: 1) Discontinuing the terms bronchioloalveolar carcinoma and mixed subtype adenocarcinoma; 2) Adding Adenocarcinoma-in-situ to the list of pre-invasive lesions; 3) Introducing the concept of minimally-invasive adenocarcinoma; 4) Classification of invasive adenocarcinomas … 3). (Qu et al. 2015). a. Columnar cells with cytoplasmic clearing. Tumor spread through alveolar spaces (“STAS”, alternately “aerogenous metastases” or “small cluster invasion”) has been linked to poorer clinical outcomes, including higher rates of lymphatic involvement and lymph node metastases (Kawakami et al. Article  2012) are important parameters in the mucinous subset as well. The anatomy of the lung. Our study is the first to look at STAS as a prognostic parameter in mucinous adenocarcinomas only. Definition / general | Case reports | Treatment | Microscopic (histologic) description. 2015; Russell et al. a, lepidic; b, acinar; c, papillary and acinar; d, focally solid. The largest diameter of the tumor was divided into < 2, 2–5, and > 5 cm size categories. The only pathologic parameters associated with outcome were STAS for lung recurrence (p = .005) and solid/cribriform growth (≥ 20% of tumor) for distant metastasis (p = 0.003). Histopathology Lung-- Adenocarcinoma - YouTube. In the 2015 WHO classification of lung tumors, minimally-invasive adenocarcinoma of the lung is defined as a small solitary adenocarcinoma measuring less than or equal to 3 cm with an invasive component less than or equal to 0.5 cm in greatest dimension. Adenocarcinoma; Lung; Model; Prognosis; Tumor grading. Although considered to be more common in mucinous adenocarcinomas than in non-mucinous tumors, the frequency and significance of its presence specifically in the mucinous subset has not been investigated. A higher proportion (11/16 or 69%) of cuboidal predominant tumors showed some TTF1 positivity; of these, 9 cases (82%) showed diffuse staining and 2 (18%) showed focal reactivity (p < 0.01). Distinguishing hepatoid adenocarcinoma of lung from hepatocellular carcinoma metastatic to lu … 2011; Travis et al. Percentage of invasion ranged from entirely lepidic to entirely invasive. Tumor nests in colloid carcinomas were not considered STAS, which by definition occurs within normal airspaces. 2015). 2015). Clusters within 0.5 mm of the tumor edge was graded as type 1 STAS, whereas clusters beyond 0.5 mm of the tumor edge and present in ≥2 low magnification (2.5 mm diameter) fields were designated as grade 2. Lung cancer is the most common cause of cancer-related mortality worldwide, and adenocarcinoma is currently the most common histologic subtype.1 Conventionally, adenocarcinomas have been grouped into 3 distinct grades including well, moderately, and poorly differentiated. National Library of Medicine Watch later. J Thorac Oncol 10:1243–1260, Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger K, Yatabe Y, Ishikawa Y, Wistuba I, Flieder DB, Franklin W, Gazdar A, Hasleton PS, Henderson DW, Kerr KM, Nakatani Y, Petersen I, Roggli V, Thunnissen E, Tsao M (2013) Diagnosis of lung adenocarcinoma in resected specimens: implications of the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification. Bethesda, MD 20894, Copyright Arch Pathol Lab Med 137:685–705, Tsuta K, Ishii G, Nitadori J, Murata Y, Kodama T, Nagai K, Ochiai A (2006) Comparison of the immunophenotypes of signet-ring cell carcinoma, solid adenocarcinoma with mucin production, and mucinous bronchioloalveolar carcinoma of the lung characterized by the presence of cytoplasmic mucin. It is defined by the presence of “abundant” intracytoplasmic mucin and has a predilection for multicentricity, large areas of in-situ growth, and by KRAS(Kirsten rat sarcoma viral oncogene) mutations. All tumors were treated and diagnosed in a single institution and were discussed in multi-disciplinary conference, with radiological and clinical evaluation and assumption of a lung primary tumor. The histopathology of lung cancer appears to be changing: The incidence of squamous cell carcinoma in the United States is declining, accompanied by the increase in the incidence of adenocarcinoma. … Part of Recently, STAS has been included as a type of invasion in the 2015 WHO classification of lung tumors. Cribriform and signet ring cell patterns correlated with colloid areas (p = 0.002 and p = 0.003, respectively). Copyright © 2020 International Association for the Study of Lung Cancer. Cai D, Li H, Wang R, Li Y, Pan Y, Hu H, Zhang Y, Gong R, Pan B, Sun Y, Chen H (2014) Comparison of clinical features, molecular alterations, and prognosis in morphological subgroups of lung invasive mucinous adenocarcinoma. 2015 Dec;90(3):568-74. doi: 10.1016/j.lungcan.2015.10.014. Lung cancer is the leading cause of cancer-related death in developed countries. Correspondence to Although 5 cases showed either entirely lepidic architecture or less than 0.5 cm of invasion, these cases were all classified as invasive mucinous adenocarcinoma due to the size (n = 3) or due to the presence of STAS (n = 2). (Rossi et al. Carcinoma of the pancreas exhibiting exocrine differentiation and lacking significant (<25%) ductal or endocrine differentiation Mucinous adenocarcinomas of the lung are similar to non-mucinous prognostically, in that STAS and solid growth are poor prognosticators, for local and distant recurrence, respectively. Types of tumor cell. Tap to unmute. https://doi.org/10.1186/s42047-018-0013-8, DOI: https://doi.org/10.1186/s42047-018-0013-8. Unable to load your collection due to an error, Unable to load your delegates due to an error. Acinar adenocarcinoma is a histological subtype of gland-forming cancer that is diagnosed when cuboidal and/or columnar shaped malignant cells in the neoplastic tissue form acini and tubules. Air travels from our mouth and nose down the airways into the lungs. J Pathol 209:78–87, Warth A, Muley T, Meister M, Stenzinger A, Thomas M, Schirmacher P, Schnabel PA, Budczies J, Hoffmann H, Weichert W (2012) The novel histologic International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification system of lung adenocarcinoma is a stage-independent predictor of survival. TTF-1 immunoreactivity, extent compared to mucin cell type. Adenocarcinoma of lung (or pulmonary adenocarcinoma) is the most commonly diagnosed type of lung cancer. Google Scholar, Geles A, Gruber-Moesenbacher U, Quehenberger F, Manzl C, Al Effah M, Grygar E, Juettner-Smolle F, Popper HH (2015) Pulmonary mucinous adenocarcinomas: architectural patterns in correlation with genetic changes, prognosis and survival. There was a significant association between STAS and lung recurrence (Fig. Accessibility Epub 2014 May 5. By using this website, you agree to our 2015) In fact, these entities were not represented in the current study despite several cases showing entirely lepidic architecture, either because of size criterion (> 3 cm) or presence of STAS. Adenocarcinoma is the non-smoker tumour - SCLC and squamous are more strongly associated with smoking. This proposal has not yet been tested in clinical datasets to determine whether it defines prognostically significant subgroups of lung adenocarcinoma. 2a-d ). Adenocarcinoma (ADC) is the most common histologic subtype of lung cancer that encompasses a heterogeneous group of malignancies with different morphologic features, etiology, and molecular changes. spreading of tissue fragments and individual cells through a knife surface. {Diaz, 1999 #45}. Colloid was defined as airspace expansion by mucus with entrapped tumor clusters, without significant lepidic spread. The degree of invasion was also characterized as absent, < 50%, and 50% or greater when measured by linear dimension in the slide in the slide with maximum diameter. The model consists of the following: grade 1, lepidic predominant tumor; grade 2, acinar or papillary predominant tumor, both with no or less than 20% of high-grade patterns; and grade 3, any tumor with 20% or more of high-grade patterns (solid, micropapillary, or complex gland). Receiver operating characteristic curve analysis was used to select the best model, which was validated (n = 212) and tested (n = 300, including stage I-III) in independent cohorts. J Clin Oncol 30:1438–1446, Watanabe M, Yokose T, Tetsukan W, Imai K, Tsuboi M, Ito H, Ishikawa Y, Yamada K, Nakayama H, Fujino S (2013) Micropapillary components in a lung adenocarcinoma predict stump recurrence 8 years after resection: a case report. Median follow-up was 40 months. There was no correlation between STAS and other histopathologic parameters. Am J Surg Pathol 37:1100–1108, Zhang Y, Wang R, Li Y, Pan Y, Hu H, Zhang Y, Li H, Shen L, Yu Y, Sun Y, Chen H (2015) Negative thyroid transcription factor 1 expression defines an unfavorable subgroup of lung adenocarcinomas. J Thorac Oncol, Rossi G, Murer B, Cavazza A, Losi L, Natali P, Marchioni A, Migaldi M, Capitanio G, Brambilla E (2004) Primary mucinous (so-called colloid) carcinomas of the lung: a clinicopathologic and immunohistochemical study with special reference to CDX-2 homeobox gene and MUC2 expression. © 2021 BioMed Central Ltd unless otherwise stated. All authors read and approved the final manuscript. volume 1, Article number: 3 (2018) Types of lung adenocarcinoma include lepidic, acinar, micropapillary, papillary, and solid. Google Scholar, Kawakami T, Nabeshima K, Hamasaki M, Iwasaki A, Shirakusa T, Iwasaki H (2009) Small cluster invasion: a possible link between micropapillary pattern and lymph node metastasis in pT1 lung adenocarcinomas. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society: international multidisciplinary classification of lung adenocarcinoma: executive summary. Pathologic parameters predicting poor outcome have not been extensively studied, including the presence of spread through alveolar spaces (STAS). Non-small cell lung cancers (NSCLC) comprise 75% of all lung cancers and consist of three major histologic types: squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. It is important to sepa-rate demosplastic stroma in this pattern from preexisting alveolar structures with thickened fibroelastic alveolar septa sometimes seen in a lepidic pattern. Tumors were classified as either showing predominantly cuboidal mucin-producing cells with eosinophilic cytoplasm, with no or a minor component of interspersed goblet cells and sometimes showing a fine brush border, or alternately showing a predominance of columnar mucin-producing cells with clear cytoplasm (goblet cells). Privacy, Help J Thorac Oncol 10:1156–1162, Strand TE, Rostad H, Strom EH, Hasleton P (2015) The percentage of lepidic growth is an independent prognostic factor in invasive adenocarcinoma of the lung. Kadota et al. Am J Surg Pathol 37:287–294. showed that in a subset of patients with peripheral, predominantly non-mucinous adenocarcinomas < 2 cm, STAS was highly associated with regional recurrence, especially in tumors that were treated with sub-lobar resections. Onco Targets Ther 7:2127–2132, PubMed  No external funding was used. Epub 2015 Aug 9. There was a significant association between distant metastasis and solid invasive growth (Fig. Adenocarcinoma in situ, either serous or mucinous . The objective of our study is to correlate histologic features, including presence and type of STAS, architectural growth patterns, percent of invasiveness, mucin cell type, and TTF1 reactivity, with clinical outcome in a series of mucinous adenocarcinomas. PubMed Central  In the former, most of the tumor cell cytoplasm contained mucin whereas the latter showed apical mucin and prominent PAS staining of the luminal surface. Adenocarcinoma (ADC) is the most common histologic type of lung cancer with an increasing prevalence, currently accounting for more than 40% of cases of non-small cell lung cancer (NSLC), occurring in smokers and non-smokers .. Tumor size included the entire lesion, invasive and non-invasive were recorded used a conventional ocular micrometer. It is of The proportions of tumors with solid cribriform, papillary, micropapillary and acinar subtypes are presented in Table 2. Privacy Lung adenocarcinoma is the most common brain metastasis. Slide Index Neuropath Breast Head & Neck Mediastinum Peritoneum Genitourinary Lymph Node/Spleen Hematopathology Gynecologic Orthopedic Endocrine DermPath Gastrointestinal Soft Tissue Pulmonary Lung … Hung JJ, Yeh YC, Jeng WJ, Wu KJ, Huang BS, Wu YC, Chou TY, Hsu WH. Of these, 14 (47% of all tumors) showed STAS limited to within 0,5 mm of the border of the tumor (27% of all tumors, grade 1) and the remainder showed STAS present beyond this distance (> 0.5 mm) (Fig. Lung cancer is the leading cause of cancer-related death in the world, and the prevalence and mortality of lung cancer are still increasing dramatically.1 The survival of lung cancer is still poor, with a 5-year survival rate below 20%.2 Approximately 80% to 85% of lung cancers are non–small cell lung cancers (NSCLCs), and the most common subtype is adenocarcinoma. Papillary adenocarcinoma of the lung is a more advanced adenocarcinoma than bronchioloalveolar carcinoma that is composed of two distinct histological subtypes. Acinar-predominant adenocarcinoma of the lung is a histological subtype of non-mucinous invasive adenocarcinoma of the lung. not applicable. 5). Mucinous adenocarcinomas of the lung account for approximately 10–15% of lung adenocarcinomas and have been reported to portend a poorer prognosis than non-mucinous adenocarcinoma (Cai et al. In contrast to areas of lepidic growth where the elastic framework of the lung is intact, acinar adenocarcinoma has stromal invasion, as evidenced by disruption of the elastic framework with bundles of broken elastic fibers seen on VVG stains accompanied by desmoplastic tumor stroma 10 … 2015) Jessurun et al. There were 7 patients (23%) with lung recurrence (mean 22 months) and 7 (23%) with distant metastases (mean 3.7 months). PathologyOutlines.com website. The proportion of invasive component, size of invasive component, size of solid invasive component, presence of STAS, TTF1 positivity, mucin cell type, and presence of histologic subtypes other than solid were correlated with outcome via Kaplan-Meier curves with log-rank statistic (JMP software, Cary, NC). The International Association for the Study of Lung cancer … Some degree of TTF-1 positivity was present in 13 cases overall (43%) (n = 11 for cuboidal predominant tumors; n = 2 for columnar predominant tumors). Recent work is now bringing lung cancer pathology into line with these other advances. Tumors classified as “colloid carcinoma”, now considered a variant of invasive adenocarcinoma, were included in the study due to significant histologic overlap with “mucinous adenocarcinoma”. (Righi et al. J Thorac Oncol 10:806–814, Kamata T, Yoshida A, Shiraishi K, Furuta K, Kosuge T, Watanabe S, Asamura H, Tsuta K (2016) Mucinous micropapillary pattern in lung adenocarcinomas: a unique histology with genetic correlates. The best model (area under the receiver operating characteristic curve [AUC] = 0.749 for RFS and 0.787 for OS) was composed of a combination of predominant plus high-grade histologic pattern with a cutoff of 20% for the latter. Eight cases (36%) showed entirely invasive architecture without a lepidic component. Mucinous adenocarcinomas of the lung are similar to non-mucinous and both STATs and solid growth represent poor prognosticators, for local and distant recurrence, respectively. Local recurrence developed in 7 patients, determined by open surgical biopsy in 6, and imaging in 1. b. PAS (with diastase pretreatment) demonstrates diffuse cytoplasmic staining with basal nuclei. Shopping. Pulmonary adenocarcinomas resected from 2003 to 2014 were retrospectively reclassified as non-mucinous invasive adenocarcinoma, colloid carcinoma, mucinous adenocarcinoma-in-situ, minimally invasive mucinous adenocarcinoma, or invasive mucinous adenocarcinoma (WHO 2015 reference). Am J Clin Pathol 139:160–166, Xu L, Tavora F, Burke A (2013) Histologic features associated with metastatic potential in invasive adenocarcinomas of the lung. (Zhang et al. The novel histologic International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification system of lung adenocarcinoma is a stage-independent predictor of survival. 4). A grading system based on the predominant and high-grade patterns is practical and prognostic for invasive pulmonary adenocarcinoma. Mucinous adenocarcinomas of the lung have been subclassified and defined in various ways. Furthermore, the text mentions that adenocarcinoma subtyping should be performed even in … {Thunnissen, 2016 #43} An older study on breast tissue describes tissue displacement in breast tissue and in a high percentage of cases. statement and showed a significantly increased 5-year recurrence-free survival for patients without STAS (“tumor islands”), in a series also of predominantly non-mucinous tumors. 2. Histopathology Lung-- Adenocarcinoma. Tumor size ranged from 0.6 to 8.2 cm. Am J Surg Pathol 28:442–452, Russell PA, Wainer Z, Wright GM, Daniels M, Conron M, Williams RA (2011) Does lung adenocarcinoma subtype predict patient survival? The most common tumors among this group are mucoepidermoid carcinoma and adenoid cystic carcinoma. Mucinous adenocarcinoma is often considered a relatively poor prognostic group among adenocarcinomas of the lung and has a high rate of pulmonary recurrence. Qu et al. c. Cuboidal cells with eosinophilic cytoplasm. Nonpredominant lepidic pattern correlates with better outcome in invasive lung adenocarcinoma. Pulmonary mucinous adenocarcinomas: a clinicopathologic series with emphasis on the prognostic significance of spread through alveolar spaces, and presence of solid growth component. Manage cookies/Do not sell my data we use in the preference centre. Cite this article. Proc Am Thorac Soc. (Xu et al. Semin Thorac Cardiovasc Surg. We and our partners process personal data such as IP Address, Unique ID, browsing data for: Use precise geolocation data | Actively scan device characteristics for identification.. Acinar Adenocarcinoma of Lung is a histological subtype of pulmonary adenocarcinoma. Introduction: https://doi.org/10.1007/s13277-015-3869-1. They are connected to the outside of the body by hollow tubes called airways. P30 CA016087/CA/NCI NIH HHS/United States. Virchows Arch 467:675–686, CAS  FT and AB participated in the design of the study and performed the statistical analysis. A new lung adenocarcinoma classification is being proposed by the International Association for the Study of Lung Cancer, American Thoracic Society and European Respiratory Society (IASLC/ATS/ERS). Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The authors declare that they have no competing interests. The current study demonstrates that STAS is a frequent finding in mucinous adenocarcinomas of the lung, rendering the newly created categories of “mucinous adenocarcinoma in situ” and “minimally invasive adenocarcinoma” very rare. The growth patterns of mucinous adenocarcinomas should be reported similar to reporting of non-mucinous adenocarcinomas. Tumors meeting criteria for mucinous adenocarcinoma (in-situ, minimally invasive, or invasive) were included in the study. New International Association for the Study of Lung Cancer (IASLC) Pathology Committee Grading System for the Prognostic Outcome of Advanced Lung Adenocarcinoma. 2013 Spring;25(1):14-21. doi: 10.1053/j.semtcvs.2013.01.003. An autopsy study by Thunissen et al. 2015; Masai et al. The relative prevalence of the neoplasm in the various salivary gland reflects the abundance of acinic cells: parotid gland (~80%) > minor salivary glands (~17%) > submandibular glands (~3%). Similar to published reports, we found STAS to be associated with poorer prognosis, but only in the sense of local recurrence. 8600 Rockville Pike AB, FT an AP conceived of the study, and participated in its design and coordination and helped to draft the manuscript. (Strand et al. We found no correlation with distant recurrence. The presence of signet ring cells as a type of solid growth was also noted. 2009), and higher rates of recurrence (Onozato et al. 2013) Onozato et al. Two tumors included in the study were classified as “colloid carcinoma” and 28 cases classified as “invasive mucinous adenocarcinoma”.
acinar adenocarcinoma lung pathology outlines 2021