Sandbox lung cancer differential
- Overlapping histologic features differentiation of primary and secondary tumors are difficult.
- 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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Epidemiology | Topography | Histology | Immunohistochemistry | Topography | Pulmonary growth pattern | Mets | Other differentiating features | ||||
Squamous cell carcinoma | Papillary |
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Clear cell | |||||||||||
Small cell | |||||||||||
Basaloid | |||||||||||
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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Epidemiology | Histopathology | Immunohistochemistry | Topography | Spread | |||
Papilloma | Squamous cell papilloma | Exophytic | |||||
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 |