Sandbox lung cancer differential: Difference between revisions
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! colspan=" | ! colspan="9" |Benign lung tumor | ||
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! colspan="3" | | ! colspan="3" | | ||
! | !Risk factors | ||
!Gross pathology | |||
!Histopathology | !Histopathology | ||
!Immunohistochemistry | !Immunohistochemistry | ||
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| rowspan="2" |Squamous cell papilloma | | rowspan="2" |Squamous cell papilloma | ||
|Exophytic | |Exophytic | ||
| rowspan="2" | | |||
* HPV 6 and 11 | |||
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* Cauliflower-like tan-white soft to semifirm excrescences protruding into bronchial lumens | |||
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* Loose fibrovascular core | |||
* Stratified squamous epithelium | |||
* Acanthosis | |||
* Wrinkled nuclei | |||
* Binucleate forms and perinuclear halos | |||
* Koilocytosis | |||
* Dyskeratotic cells | |||
* Large atypical cells | |||
* Occasional mitotic figures | |||
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| | |Endobronchial | ||
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| colspan="2" |Glandular papilloma | | colspan="2" |Glandular papilloma | ||
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| colspan="2" |Mixed squamous cell and glandular papilloma | | colspan="2" |Mixed squamous cell and glandular papilloma | ||
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| rowspan="9" |Adenomas | | rowspan="9" |Adenomas | ||
| colspan="2" |Alveolar adenoma | | colspan="2" |Alveolar adenoma | ||
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| colspan="2" |Papillary adenoma | | colspan="2" |Papillary adenoma | ||
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| rowspan="2" |Adenomas of the salivary gland type | | rowspan="2" |Adenomas of the salivary gland type | ||
|Mucous gland adenoma | |Mucous gland adenoma | ||
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|Pleomorphic adenoma | |Pleomorphic adenoma | ||
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| colspan="2" |Mucinous cystadenoma | | colspan="2" |Mucinous cystadenoma | ||
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| rowspan="4" |Lymphoproliferative tumors | | rowspan="4" |Lymphoproliferative tumors | ||
|Marginal zone B-cell lymphoma of the MALT type | |Marginal zone B-cell lymphoma of the MALT type | ||
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|Diffuse large B-cell lymphoma | |Diffuse large B-cell lymphoma | ||
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|Lymphomatoid granulomatosis | |Lymphomatoid granulomatosis | ||
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|Langerhans cell histiocytosis | |Langerhans cell histiocytosis | ||
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| rowspan="8" |Miscellaneous tumors | | rowspan="8" |Miscellaneous tumors | ||
| colspan="2" |Harmatoma | | colspan="2" |Harmatoma | ||
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| colspan="2" |Sclerosing hemangioma | | colspan="2" |Sclerosing hemangioma | ||
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| colspan="2" |Clear cell tumor | | colspan="2" |Clear cell tumor | ||
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| rowspan="3" |Germ cell tumors | | rowspan="3" |Germ cell tumors | ||
|Mature tratoma | |Mature tratoma | ||
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|Immature teratoma | |Immature teratoma | ||
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|Other germ cell tumours | |Other germ cell tumours | ||
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| colspan="2" |Intrapulmonary thymoma | | colspan="2" |Intrapulmonary thymoma | ||
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| colspan="2" |Melanoma | | colspan="2" |Melanoma | ||
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| colspan="3" |Metastatic tumors | | colspan="3" |Metastatic tumors | ||
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Revision as of 19:39, 5 March 2018
- Differentiation of primary and secondary lun tumors is difficult due to overlapping histologic features.
- Topography, size and form of pulmonary growth pattern are important aspects for the differential diagnosis.
- Primary lung tumors are mainly localized in upper lobes as singular nodules, metastases in lower lobes as multiple lesions.
- On the contarary, endobronchial primary or secondary squamous cell carcinomas findings of severe dysplasia and CIS of the bronchial epithelium are important.
- Stroma and vascularisation pattern of primary and secondary lung tumors differ in distribution, arrangement and extracellular matrix components.
- Pulmonary vascular changes in primary tumors are characterized by vascular infiltration, destruction and occlusion whereas in secondary tumors intravascular embolisation and extravasation predominate.
Malignant lung carcnimoma | |||||||||||||
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Risk Factors | Topography | Histology | Gross | Immunohistochemistry | Imaging | Pulmonary growth pattern | Mets | Other differentiating features | |||||
Xray | CT | PET scan | |||||||||||
Squamous cell carcinoma | Papillary |
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Clear cell |
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Small cell |
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Basaloid |
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Small cell carcinoma | Combined small cell carcinoma | ||||||||||||
Adeno carcinoma | Adenocarcinoma, mixed sub type | ||||||||||||
Acinar adenocarcinoma | |||||||||||||
Papillary adenocarcinoma | |||||||||||||
Bronchio-alveolar carcinoma | Non-mucinous | ||||||||||||
Mucinous | |||||||||||||
Mixed non-mucinous and mucinous or indeterminate | |||||||||||||
Solid adenocarcinoma with mucin production | Fetal adenocarcinoma | ||||||||||||
Mucinous (“colloid”) carcinoma | |||||||||||||
Mucinous cystadenocarcinoma | |||||||||||||
Signet ring adenocarcinoma | |||||||||||||
Clear cell adenocarcinoma | |||||||||||||
Large cell carcinoma | Giant-cell carcinoma of the lung | ||||||||||||
Basaloid large cell carcinoma of the lung | |||||||||||||
Clear cell carcinoma of the lung | |||||||||||||
Lymphoepithelioma-like carcinoma of the lung | |||||||||||||
Large-cell lung carcinoma with rhabdoid phenotype | |||||||||||||
Large cell neuroendocrine carcinoma of the lung | |||||||||||||
Sarcomatoid carcinoma | Pleomorphic carcinoma | ||||||||||||
Carcinosarcoma | |||||||||||||
Spindle cell carcinoma | |||||||||||||
Giant cell carcinoma | |||||||||||||
Pulmonary blastoma | |||||||||||||
Carcinoid tumour | Typical carcinoid | ||||||||||||
Atypical carcinoid | |||||||||||||
Salivary gland tumours | Mucoepidermoid carcinoma | ||||||||||||
Adenoid cystic carcinoma | |||||||||||||
Epithelial-myoepithelial carcinoma | |||||||||||||
Preinvasive lesions | Squamous carcinoma in situ | ||||||||||||
Atypical adenomatous hyperplasia | |||||||||||||
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia | |||||||||||||
Mesenchymal tumors | Epithelioid haemangioendothelioma | ||||||||||||
Angiosarcoma | |||||||||||||
Pleuropulmonary blastoma | |||||||||||||
Chondroma | |||||||||||||
Congenital peribronchial myofibroblastic tumor | |||||||||||||
Diffuse pulmonary lymphangiomatosis | |||||||||||||
Inflammatory myofibroblastic tumor | |||||||||||||
Synovial sarcoma
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Pulmonary artery sarcoma | |||||||||||||
Pulmonary vein sarcoma |
Benign lung tumor | ||||||||
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Risk factors | Gross pathology | Histopathology | Immunohistochemistry | Topography | Spread | |||
Papilloma | Squamous cell papilloma | Exophytic |
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Endobronchial | ||
Inverted | ||||||||
Glandular papilloma | ||||||||
Mixed squamous cell and glandular papilloma | ||||||||
Adenomas | Alveolar adenoma | |||||||
Papillary adenoma | ||||||||
Adenomas of the salivary gland type | Mucous gland adenoma | |||||||
Pleomorphic adenoma | ||||||||
Mucinous cystadenoma | ||||||||
Lymphoproliferative tumors | Marginal zone B-cell lymphoma of the MALT type | |||||||
Diffuse large B-cell lymphoma | ||||||||
Lymphomatoid granulomatosis | ||||||||
Langerhans cell histiocytosis | ||||||||
Miscellaneous tumors | Harmatoma | |||||||
Sclerosing hemangioma | ||||||||
Clear cell tumor | ||||||||
Germ cell tumors | Mature tratoma | |||||||
Immature teratoma | ||||||||
Other germ cell tumours | ||||||||
Intrapulmonary thymoma | ||||||||
Melanoma | ||||||||
Metastatic tumors |