Sandbox lung cancer differential: Difference between revisions
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* Topography, size and form of pulmonary growth pattern are important aspects for the differential diagnosis. | * Topography, size and form of pulmonary growth pattern are important aspects for the differential diagnosis. | ||
* '''<u>The following table summarizes the differentiation of various lung tumors based on histological and topographical features:</u>'''<ref name="pmid10682770">{{cite journal |vauthors=Erasmus JJ, Connolly JE, McAdams HP, Roggli VL |title=Solitary pulmonary nodules: Part I. Morphologic evaluation for differentiation of benign and malignant lesions |journal=Radiographics |volume=20 |issue=1 |pages=43–58 |date=2000 |pmid=10682770 |doi=10.1148/radiographics.20.1.g00ja0343 |url=}}</ref> | * '''<u>The following table summarizes the differentiation of various lung tumors based on histological and topographical features:</u>'''<ref name="pmid10682770">{{cite journal |vauthors=Erasmus JJ, Connolly JE, McAdams HP, Roggli VL |title=Solitary pulmonary nodules: Part I. Morphologic evaluation for differentiation of benign and malignant lesions |journal=Radiographics |volume=20 |issue=1 |pages=43–58 |date=2000 |pmid=10682770 |doi=10.1148/radiographics.20.1.g00ja0343 |url=}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
! colspan="11" |Benign Lung Tumors<ref name="pmid23077446">{{cite journal |vauthors=Gümüştaş S, Inan N, Akansel G, Ciftçi E, Demirci A, Ozkara SK |title=Differentiation of malignant and benign lung lesions with diffusion-weighted MR imaging |journal=Radiol Oncol |volume=46 |issue=2 |pages=106–13 |date=June 2012 |pmid=23077446 |pmc=3472932 |doi=10.2478/v10019-012-0021-3 |url=}}</ref> | ! colspan="11" style="background:#4479BA; color: #FFFFFF;" align="center" + |Benign Lung Tumors<ref name="pmid23077446">{{cite journal |vauthors=Gümüştaş S, Inan N, Akansel G, Ciftçi E, Demirci A, Ozkara SK |title=Differentiation of malignant and benign lung lesions with diffusion-weighted MR imaging |journal=Radiol Oncol |volume=46 |issue=2 |pages=106–13 |date=June 2012 |pmid=23077446 |pmc=3472932 |doi=10.2478/v10019-012-0021-3 |url=}}</ref> | ||
|- | |- | ||
! colspan="3" |Benign lung tumor | ! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Benign lung tumor | ||
!Risk/Epidemiology | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Risk/Epidemiology | ||
!Pleuripotent cells | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Pleuripotent cells | ||
!Topography | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Topography | ||
!Gross | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gross | ||
!Histology | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Histology | ||
!Immunohistochemistry | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Immunohistochemistry | ||
!Imaging | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Imaging | ||
!Metastasis | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Metastasis | ||
|- | |- | ||
| rowspan="2" |'''[[Papilloma]]'''<ref name="pmid3969658">{{cite journal |vauthors=Maxwell RJ, Gibbons JR, O'Hara MD |title=Solitary squamous papilloma of the bronchus |journal=Thorax |volume=40 |issue=1 |pages=68–71 |date=January 1985 |pmid=3969658 |pmc=459982 |doi= |url=}}</ref> | | rowspan="2" style="background:#DCDCDC;" align="center" + |'''[[Papilloma]]'''<ref name="pmid3969658">{{cite journal |vauthors=Maxwell RJ, Gibbons JR, O'Hara MD |title=Solitary squamous papilloma of the bronchus |journal=Thorax |volume=40 |issue=1 |pages=68–71 |date=January 1985 |pmid=3969658 |pmc=459982 |doi= |url=}}</ref> | ||
| colspan="2" |'''[[Squamous cell papilloma]]''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''[[Squamous cell papilloma]]''' | ||
| | | | ||
* [[Human papillomavirus|HPV 6]] and [[Human papillomavirus|11]] | * [[Human papillomavirus|HPV 6]] and [[Human papillomavirus|11]] | ||
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* N/A | * N/A | ||
|- | |- | ||
| colspan="2" |'''Glandular papilloma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Glandular papilloma''' | ||
| | | | ||
* Rare | * Rare | ||
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* N/A | * N/A | ||
|- | |- | ||
| rowspan="3" |'''Adenom'''a<ref name="pmid9817965">{{cite journal |vauthors=Shiota Y, Matsumoto H, Sasaki N, Taniyama K, Hashimoto S, Sueishi K |title=Solitary bronchioloalveolar adenoma of the lung |journal=Respiration |volume=65 |issue=6 |pages=483–5 |date=1998 |pmid=9817965 |doi=10.1159/000029319 |url=}}</ref> | | rowspan="3" style="background:#DCDCDC;" align="center" + |'''Adenom'''a<ref name="pmid9817965">{{cite journal |vauthors=Shiota Y, Matsumoto H, Sasaki N, Taniyama K, Hashimoto S, Sueishi K |title=Solitary bronchioloalveolar adenoma of the lung |journal=Respiration |volume=65 |issue=6 |pages=483–5 |date=1998 |pmid=9817965 |doi=10.1159/000029319 |url=}}</ref> | ||
| colspan="2" |'''Alveolar adenoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Alveolar adenoma''' | ||
| | | | ||
* Mean age of diagnosis is 53 years | * Mean age of diagnosis is 53 years | ||
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* N/A | * N/A | ||
|- | |- | ||
| colspan="2" |'''Papillary adenoma'''<ref name="pmid28409070">{{cite journal |vauthors=Kanchustambham V, Saladi S, Patolia S, Mahmoud Assaf S, Stoeckel D |title=A Rare Case of a Benign Primary Pleomorphic Adenoma of the Lung |journal=Cureus |volume=9 |issue=3 |pages=e1069 |date=March 2017 |pmid=28409070 |pmc=5375953 |doi=10.7759/cureus.1069 |url=}}</ref> | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Papillary adenoma'''<ref name="pmid28409070">{{cite journal |vauthors=Kanchustambham V, Saladi S, Patolia S, Mahmoud Assaf S, Stoeckel D |title=A Rare Case of a Benign Primary Pleomorphic Adenoma of the Lung |journal=Cureus |volume=9 |issue=3 |pages=e1069 |date=March 2017 |pmid=28409070 |pmc=5375953 |doi=10.7759/cureus.1069 |url=}}</ref> | ||
| | | | ||
* Mean age of diagnosis is 32 years | * Mean age of diagnosis is 32 years | ||
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* N/A | * N/A | ||
|- | |- | ||
| colspan="2" |'''Mucinous cystadenoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Mucinous cystadenoma''' | ||
| | | | ||
* No sex predilection | * No sex predilection | ||
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* N/A | * N/A | ||
|- | |- | ||
! colspan="11" |Malignant Lung Tumors<ref name="pmid7863581">{{cite journal |vauthors=Kelley LC, Puette M, Langheinrich KA, King B |title=Bovine pulmonary blastomas: histomorphologic description and immunohistochemistry |journal=Vet. Pathol. |volume=31 |issue=6 |pages=658–62 |date=November 1994 |pmid=7863581 |doi=10.1177/030098589403100605 |url=}}</ref> | ! colspan="11" style="background:#4479BA; color: #FFFFFF;" align="center" + |Malignant Lung Tumors<ref name="pmid7863581">{{cite journal |vauthors=Kelley LC, Puette M, Langheinrich KA, King B |title=Bovine pulmonary blastomas: histomorphologic description and immunohistochemistry |journal=Vet. Pathol. |volume=31 |issue=6 |pages=658–62 |date=November 1994 |pmid=7863581 |doi=10.1177/030098589403100605 |url=}}</ref> | ||
|- | |- | ||
! colspan="3" |Variants of lung carcinoma | ! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Variants of lung carcinoma | ||
!Risk Factors/Epidemiology | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Risk Factors/Epidemiology | ||
!Pleuripotent cell | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Pleuripotent cell | ||
!Topography | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Topography | ||
!Gross | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gross | ||
!Histology | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Histology | ||
!Immunohistochemistry | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Immunohistochemistry | ||
!Imaging | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Imaging | ||
!Metastasis | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Metastasis | ||
|- | |- | ||
| rowspan="4" |'''[[Squamous cell carcinoma of the lung|Squamous cell carcinoma]] (SCC)'''<ref name="pmid5528918">{{cite journal |vauthors=Roth E, Smidt D |title=[Studies on early ejaculate collection using electroejaculation in German improved land-swines and Goettinger miniature pigs] |language=German |journal=Berl. Munch. Tierarztl. Wochenschr. |volume=83 |issue=1 |pages=7–11 |date=January 1970 |pmid=5528918 |doi= |url=}}</ref> | | rowspan="4" style="background:#DCDCDC;" align="center" + |'''[[Squamous cell carcinoma of the lung|Squamous cell carcinoma]] (SCC)'''<ref name="pmid5528918">{{cite journal |vauthors=Roth E, Smidt D |title=[Studies on early ejaculate collection using electroejaculation in German improved land-swines and Goettinger miniature pigs] |language=German |journal=Berl. Munch. Tierarztl. Wochenschr. |volume=83 |issue=1 |pages=7–11 |date=January 1970 |pmid=5528918 |doi= |url=}}</ref> | ||
| colspan="2" |'''Papillary''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Papillary''' | ||
| rowspan="4" | | | rowspan="4" | | ||
* Cigarette smokers | * Cigarette smokers | ||
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| rowspan="4" | | | rowspan="4" | | ||
|- | |- | ||
| colspan="2" |'''Clear cell''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Clear cell''' | ||
| | | | ||
* Cells with clear [[cytoplasm]] | * Cells with clear [[cytoplasm]] | ||
|- | |- | ||
| colspan="2" |'''Small cell''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Small cell''' | ||
| | | | ||
* Poorly differentiated cells | * Poorly differentiated cells | ||
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* Intercellular bridges or [[keratinization]] | * Intercellular bridges or [[keratinization]] | ||
|- | |- | ||
| colspan="2" |'''Basaloid''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Basaloid''' | ||
| | | | ||
* Peripheral palisading of nuclei. | * Peripheral palisading of nuclei. | ||
* Poor differentiation | * Poor differentiation | ||
|- | |- | ||
| colspan="3" |'''[[Small cell carcinoma]]'''<ref name="pmid16226617">{{cite journal |vauthors=Jackman DM, Johnson BE |title=Small-cell lung cancer |journal=Lancet |volume=366 |issue=9494 |pages=1385–96 |date=2005 |pmid=16226617 |doi=10.1016/S0140-6736(05)67569-1 |url=}}</ref> | | colspan="3" style="background:#DCDCDC;" align="center" + |'''[[Small cell carcinoma]]'''<ref name="pmid16226617">{{cite journal |vauthors=Jackman DM, Johnson BE |title=Small-cell lung cancer |journal=Lancet |volume=366 |issue=9494 |pages=1385–96 |date=2005 |pmid=16226617 |doi=10.1016/S0140-6736(05)67569-1 |url=}}</ref> | ||
| | | | ||
* [[Smoking]] | * [[Smoking]] | ||
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* Liver | * Liver | ||
|- | |- | ||
| rowspan="10" |'''[[Adenocarcinoma]]'''<ref name="Kumar-adenocarcinoma">{{cite book |chapter=Chapter 13, box on morphology of adenocarcinoma |author=Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson |title=Robbins Basic Pathology|publisher=Saunders |location=Philadelphia |isbn=1-4160-2973-7 |edition=8th}}</ref><ref name="pmid17625570">{{cite journal| author=Soda M, Choi YL, Enomoto M, Takada S, Yamashita Y, Ishikawa S et al.| title=Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer. | journal=Nature | year= 2007 | volume= 448 | issue= 7153 | pages= 561-6 | pmid=17625570 | doi=10.1038/nature05945 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17625570 }}</ref><ref>Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg</ref> | | rowspan="10" style="background:#DCDCDC;" align="center" + |'''[[Adenocarcinoma]]'''<ref name="Kumar-adenocarcinoma">{{cite book |chapter=Chapter 13, box on morphology of adenocarcinoma |author=Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson |title=Robbins Basic Pathology|publisher=Saunders |location=Philadelphia |isbn=1-4160-2973-7 |edition=8th}}</ref><ref name="pmid17625570">{{cite journal| author=Soda M, Choi YL, Enomoto M, Takada S, Yamashita Y, Ishikawa S et al.| title=Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer. | journal=Nature | year= 2007 | volume= 448 | issue= 7153 | pages= 561-6 | pmid=17625570 | doi=10.1038/nature05945 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17625570 }}</ref><ref>Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg</ref> | ||
| colspan="2" |'''Acinar adenocarcinoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Acinar adenocarcinoma''' | ||
| rowspan="10" | | | rowspan="10" | | ||
* [[Smoking]] | * [[Smoking]] | ||
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* Liver | * Liver | ||
|- | |- | ||
| colspan="2" |'''Papillary adenocarcinoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Papillary adenocarcinoma''' | ||
| | | | ||
* [[Papillae]] | * [[Papillae]] | ||
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* [[Mucinous]] or non-mucinous | * [[Mucinous]] or non-mucinous | ||
|- | |- | ||
| rowspan="3" |'''Bronchio-alveolar carcinoma''' | | rowspan="3" style="background:#DCDCDC;" align="center" + |'''Bronchio-alveolar carcinoma''' | ||
|'''Non-mucinous''' | | style="background:#DCDCDC;" align="center" + |'''Non-mucinous''' | ||
| | | | ||
* [[Clara cell|Clara cells]] | * [[Clara cell|Clara cells]] | ||
* [[Pneumocytes|Type II cells]] | * [[Pneumocytes|Type II cells]] | ||
|- | |- | ||
|'''Mucinous''' | | style="background:#DCDCDC;" align="center" + |'''Mucinous''' | ||
| | | | ||
* Low grade differentiation | * Low grade differentiation | ||
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* Cytologic atypia | * Cytologic atypia | ||
|- | |- | ||
|'''Mixed non-mucinous and mucinous or indeterminate''' | | style="background:#DCDCDC;" align="center" + |'''Mixed non-mucinous and mucinous or indeterminate''' | ||
| | | | ||
|- | |- | ||
| rowspan="5" |'''Solid adenocarcinoma with mucin production''' | | rowspan="5" style="background:#DCDCDC;" align="center" + |'''Solid adenocarcinoma with mucin production''' | ||
|'''Fetal adenocarcinoma''' | | style="background:#DCDCDC;" align="center" + |'''Fetal adenocarcinoma''' | ||
| | | | ||
* Consists glandular elements: | * Consists glandular elements: | ||
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** Rounded morules of polygonal cells with abundant [[eosinophilic]] and finely granular [[cytoplasm]] | ** Rounded morules of polygonal cells with abundant [[eosinophilic]] and finely granular [[cytoplasm]] | ||
|- | |- | ||
|'''Mucinous (“colloid”) carcinoma''' | | style="background:#DCDCDC;" align="center" + |'''Mucinous (“colloid”) carcinoma''' | ||
| | | | ||
* Dissecting pools of [[mucin]] containing [[neoplastic]] cells | * Dissecting pools of [[mucin]] containing [[neoplastic]] cells | ||
|- | |- | ||
|'''Mucinous cystadenocarcinoma''' | | style="background:#DCDCDC;" align="center" + |'''Mucinous cystadenocarcinoma''' | ||
| | | | ||
* Partial [[fibrous tissue]] capsule | * Partial [[fibrous tissue]] capsule | ||
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* [[Neoplastic]] [[mucinous]] [[epithelium]] grows along alveolar walls | * [[Neoplastic]] [[mucinous]] [[epithelium]] grows along alveolar walls | ||
|- | |- | ||
|'''Signet ring adenocarcinoma''' | | style="background:#DCDCDC;" align="center" + |'''Signet ring adenocarcinoma''' | ||
| | | | ||
|- | |- | ||
|'''Clear cell adenocarcinoma''' | | style="background:#DCDCDC;" align="center" + |'''Clear cell adenocarcinoma''' | ||
| | | | ||
|- | |- | ||
| rowspan="5" |'''[[Large cell carcinoma of the lung|Large cell carcinoma]]'''<ref name="pmid24221342">{{cite journal |vauthors=Rossi G, Mengoli MC, Cavazza A, Nicoli D, Barbareschi M, Cantaloni C, Papotti M, Tironi A, Graziano P, Paci M, Stefani A, Migaldi M, Sartori G, Pelosi G |title=Large cell carcinoma of the lung: clinically oriented classification integrating immunohistochemistry and molecular biology |journal=Virchows Arch. |volume=464 |issue=1 |pages=61–8 |date=January 2014 |pmid=24221342 |doi=10.1007/s00428-013-1501-6 |url=}}</ref> | | rowspan="5" style="background:#DCDCDC;" align="center" + |'''[[Large cell carcinoma of the lung|Large cell carcinoma]]'''<ref name="pmid24221342">{{cite journal |vauthors=Rossi G, Mengoli MC, Cavazza A, Nicoli D, Barbareschi M, Cantaloni C, Papotti M, Tironi A, Graziano P, Paci M, Stefani A, Migaldi M, Sartori G, Pelosi G |title=Large cell carcinoma of the lung: clinically oriented classification integrating immunohistochemistry and molecular biology |journal=Virchows Arch. |volume=464 |issue=1 |pages=61–8 |date=January 2014 |pmid=24221342 |doi=10.1007/s00428-013-1501-6 |url=}}</ref> | ||
| colspan="2" |'''Basaloid large cell carcinoma of the lung''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Basaloid large cell carcinoma of the lung''' | ||
| rowspan="5" | | | rowspan="5" | | ||
* Approximately 10% of lung cancers | * Approximately 10% of lung cancers | ||
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* [[Pericardium]] | * [[Pericardium]] | ||
|- | |- | ||
| colspan="2" |'''Clear cell carcinoma of the lung''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Clear cell carcinoma of the lung''' | ||
| | | | ||
* [[Clear cell|Clear cells]] | * [[Clear cell|Clear cells]] | ||
|- | |- | ||
| colspan="2" |'''Lymphoepithelioma-like carcinoma of the lung''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Lymphoepithelioma-like carcinoma of the lung''' | ||
| | | | ||
* Syncytial growth pattern | * Syncytial growth pattern | ||
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* [[Amyloid]] deposition | * [[Amyloid]] deposition | ||
|- | |- | ||
| colspan="2" |'''Large-cell lung carcinoma with rhabdoid phenotype''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Large-cell lung carcinoma with rhabdoid phenotype''' | ||
| | | | ||
* [[Eosinophilic]] [[cytoplasmic]] globules | * [[Eosinophilic]] [[cytoplasmic]] globules | ||
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* [[Eosinophilic]] inclusions | * [[Eosinophilic]] inclusions | ||
|- | |- | ||
| colspan="2" |'''Mixed type''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Mixed type''' | ||
| | | | ||
* Mixture of: | * Mixture of: | ||
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** Spindle cell carcinoma | ** Spindle cell carcinoma | ||
|- | |- | ||
| rowspan="5" |'''Sarcomatoid carcinoma'''<ref name="pmid24088577">{{cite journal |vauthors=Huang SY, Shen SJ, Li XY |title=Pulmonary sarcomatoid carcinoma: a clinicopathologic study and prognostic analysis of 51 cases |journal=World J Surg Oncol |volume=11 |issue= |pages=252 |date=October 2013 |pmid=24088577 |pmc=3850921 |doi=10.1186/1477-7819-11-252 |url=}}</ref> | | rowspan="5" style="background:#DCDCDC;" align="center" + |'''Sarcomatoid carcinoma'''<ref name="pmid24088577">{{cite journal |vauthors=Huang SY, Shen SJ, Li XY |title=Pulmonary sarcomatoid carcinoma: a clinicopathologic study and prognostic analysis of 51 cases |journal=World J Surg Oncol |volume=11 |issue= |pages=252 |date=October 2013 |pmid=24088577 |pmc=3850921 |doi=10.1186/1477-7819-11-252 |url=}}</ref> | ||
| colspan="2" |'''Carcinosarcoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Carcinosarcoma''' | ||
| rowspan="5" | | | rowspan="5" | | ||
* Accounts for only 0.3-1.3% of all lung malignancies | * Accounts for only 0.3-1.3% of all lung malignancies | ||
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* [[Kidney]] | * [[Kidney]] | ||
|- | |- | ||
| colspan="2" |'''Spindle cell carcinoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Spindle cell carcinoma''' | ||
| | | | ||
* Only spindle shaped tumor cells | * Only spindle shaped tumor cells | ||
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* [[TTF-1]] | * [[TTF-1]] | ||
|- | |- | ||
| colspan="2" |'''Giant cell carcinoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Giant cell carcinoma''' | ||
| | | | ||
* Multi- and/or mononucleated tumor [[giant cells]] | * Multi- and/or mononucleated tumor [[giant cells]] | ||
|- | |- | ||
| colspan="2" |'''Pleomorphic carcinoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Pleomorphic carcinoma''' | ||
| | | | ||
* Poorly differentiated | * Poorly differentiated | ||
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* Fibrous or myxoid [[stroma]] | * Fibrous or myxoid [[stroma]] | ||
|- | |- | ||
| colspan="2" |'''Pulmonary blastoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Pulmonary blastoma''' | ||
| | | | ||
* Biphasic | * Biphasic | ||
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* [[Chromogranin A]] | * [[Chromogranin A]] | ||
|- | |- | ||
|'''[[Carcinoid tumor]]'''<ref name="pmid19212636">{{cite journal |vauthors=Dahabreh J, Stathopoulos GP, Koutantos J, Rigatos S |title=Lung carcinoid tumor biology: treatment and survival |journal=Oncol. Rep. |volume=21 |issue=3 |pages=757–60 |date=March 2009 |pmid=19212636 |doi= |url=}}</ref> | | style="background:#DCDCDC;" align="center" + |'''[[Carcinoid tumor]]'''<ref name="pmid19212636">{{cite journal |vauthors=Dahabreh J, Stathopoulos GP, Koutantos J, Rigatos S |title=Lung carcinoid tumor biology: treatment and survival |journal=Oncol. Rep. |volume=21 |issue=3 |pages=757–60 |date=March 2009 |pmid=19212636 |doi= |url=}}</ref> | ||
| colspan="2" |'''Typical carcinoid''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Typical carcinoid''' | ||
'''Atypical carcinoid''' | '''Atypical carcinoid''' | ||
| | | | ||
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* [[Bone]] | * [[Bone]] | ||
|- | |- | ||
| rowspan="3" |'''Salivary gland tumors'''<ref name="pmid23789697">{{cite journal |vauthors=Elnayal A, Moran CA, Fox PS, Mawlawi O, Swisher SG, Marom EM |title=Primary salivary gland-type lung cancer: imaging and clinical predictors of outcome |journal=AJR Am J Roentgenol |volume=201 |issue=1 |pages=W57–63 |date=July 2013 |pmid=23789697 |pmc=3767141 |doi=10.2214/AJR.12.9579 |url=}}</ref> | | rowspan="3" style="background:#DCDCDC;" align="center" + |'''Salivary gland tumors'''<ref name="pmid23789697">{{cite journal |vauthors=Elnayal A, Moran CA, Fox PS, Mawlawi O, Swisher SG, Marom EM |title=Primary salivary gland-type lung cancer: imaging and clinical predictors of outcome |journal=AJR Am J Roentgenol |volume=201 |issue=1 |pages=W57–63 |date=July 2013 |pmid=23789697 |pmc=3767141 |doi=10.2214/AJR.12.9579 |url=}}</ref> | ||
| colspan="2" |'''[[Mucoepidermoid carcinoma]]''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''[[Mucoepidermoid carcinoma]]''' | ||
| | | | ||
* Most patients presents in the third and fourth decade | * Most patients presents in the third and fourth decade | ||
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* [[Brain]] | * [[Brain]] | ||
|- | |- | ||
| colspan="2" |'''Adenoid cystic carcinoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Adenoid cystic carcinoma''' | ||
| | | | ||
* Constitutes less than 1% of all lung tumors | * Constitutes less than 1% of all lung tumors | ||
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* [[Adrenal glands]] | * [[Adrenal glands]] | ||
|- | |- | ||
| colspan="2" |'''Epithelial-myoepithelial carcinoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Epithelial-myoepithelial carcinoma''' | ||
| | | | ||
* Age ranges from 33 to 71 years | * Age ranges from 33 to 71 years | ||
Line 600: | Line 601: | ||
* [[Breast]] | * [[Breast]] | ||
|- | |- | ||
| rowspan="3" |'''Preinvasive lesions'''<ref name="pmid11980589">{{cite journal |vauthors=Greenberg AK, Yee H, Rom WN |title=Preneoplastic lesions of the lung |journal=Respir. Res. |volume=3 |issue= |pages=20 |date=2002 |pmid=11980589 |pmc=107849 |doi= |url=}}</ref> | | rowspan="3" style="background:#DCDCDC;" align="center" + |'''Preinvasive lesions'''<ref name="pmid11980589">{{cite journal |vauthors=Greenberg AK, Yee H, Rom WN |title=Preneoplastic lesions of the lung |journal=Respir. Res. |volume=3 |issue= |pages=20 |date=2002 |pmid=11980589 |pmc=107849 |doi= |url=}}</ref> | ||
| colspan="2" |'''Squamous carcinoma in situ''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Squamous carcinoma in situ''' | ||
| rowspan="3" | | | rowspan="3" | | ||
* Most commonly seen in fifth or sixth decades | * Most commonly seen in fifth or sixth decades | ||
Line 641: | Line 642: | ||
* [[Spleen]] | * [[Spleen]] | ||
|- | |- | ||
| colspan="2" |'''Atypical adenomatous hyperplasia''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Atypical adenomatous hyperplasia''' | ||
| | | | ||
* Surfactant apoprotein | * Surfactant apoprotein | ||
Line 672: | Line 673: | ||
* Ground-glass opacity | * Ground-glass opacity | ||
|- | |- | ||
| colspan="2" |'''Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia''' | ||
| | | | ||
* [[Pulmonary]] [[neuroendocrine cells]] | * [[Pulmonary]] [[neuroendocrine cells]] | ||
Line 698: | Line 699: | ||
* Thickened [[bronchial]] and bronchiolar walls | * Thickened [[bronchial]] and bronchiolar walls | ||
|- | |- | ||
| rowspan="8" |'''Mesenchymal tumors'''<ref name="pmid24407922">{{cite journal |vauthors=Koenigkam-Santos M, Sommer G, Puderbach M, Safi S, Schnabel PA, Kauczor HU, Heussel CP |title=Primary intrathoracic malignant mesenchymal tumours: computed tomography features of a rare group of chest neoplasms |journal=Insights Imaging |volume=5 |issue=2 |pages=237–44 |date=April 2014 |pmid=24407922 |pmc=3999366 |doi=10.1007/s13244-013-0306-0 |url=}}</ref> | | rowspan="8" style="background:#DCDCDC;" align="center" + |'''Mesenchymal tumors'''<ref name="pmid24407922">{{cite journal |vauthors=Koenigkam-Santos M, Sommer G, Puderbach M, Safi S, Schnabel PA, Kauczor HU, Heussel CP |title=Primary intrathoracic malignant mesenchymal tumours: computed tomography features of a rare group of chest neoplasms |journal=Insights Imaging |volume=5 |issue=2 |pages=237–44 |date=April 2014 |pmid=24407922 |pmc=3999366 |doi=10.1007/s13244-013-0306-0 |url=}}</ref> | ||
| colspan="2" |'''Epithelioid haemangioendothelioma / Angiosarcoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Epithelioid haemangioendothelioma / Angiosarcoma''' | ||
| | | | ||
* Caucasian | * Caucasian | ||
Line 739: | Line 740: | ||
* [[Soft tissue]] | * [[Soft tissue]] | ||
|- | |- | ||
| colspan="2" |'''Pleuropulmonary blastoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Pleuropulmonary blastoma''' | ||
| | | | ||
* Most common in children | * Most common in children | ||
Line 777: | Line 778: | ||
* [[Pancreas]] | * [[Pancreas]] | ||
|- | |- | ||
| colspan="2" |'''Chondroma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Chondroma''' | ||
| | | | ||
* Young women | * Young women | ||
Line 806: | Line 807: | ||
* [[Benign tumor]] | * [[Benign tumor]] | ||
|- | |- | ||
| colspan="2" |'''Congenital peribronchial myofibroblastic tumor''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Congenital peribronchial myofibroblastic tumor''' | ||
| | | | ||
* Rare | * Rare | ||
Line 837: | Line 838: | ||
| | | | ||
|- | |- | ||
| colspan="2" |'''Diffuse pulmonary lymphangiomatosis''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Diffuse pulmonary lymphangiomatosis''' | ||
| | | | ||
* Children | * Children | ||
Line 869: | Line 870: | ||
| | | | ||
|- | |- | ||
| colspan="2" |'''Inflammatory myofibroblastic tumor''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Inflammatory myofibroblastic tumor''' | ||
| | | | ||
* Previous [[viral infections]] | * Previous [[viral infections]] | ||
Line 912: | Line 913: | ||
* Rare | * Rare | ||
|- | |- | ||
| colspan="2" |'''Pulmonary artery sarcoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Pulmonary artery sarcoma''' | ||
| | | | ||
* Mean age of diagnosis is 49.3 years | * Mean age of diagnosis is 49.3 years | ||
Line 951: | Line 952: | ||
* [[Mediastinum]] | * [[Mediastinum]] | ||
|- | |- | ||
| colspan="2" |'''Pulmonary vein sarcoma''' | | colspan="2" style="background:#DCDCDC;" align="center" + |'''Pulmonary vein sarcoma''' | ||
| | | | ||
* Most common in women | * Most common in women |
Revision as of 18:14, 21 March 2018
- Differentiation of primary and secondary lung tumors is difficult due to overlapping histologic features.
- Topography, size and form of pulmonary growth pattern are important aspects for the differential diagnosis.
- The following table summarizes the differentiation of various lung tumors based on histological and topographical features:[1]
Benign Lung Tumors[2] | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Benign lung tumor | Risk/Epidemiology | Pleuripotent cells | Topography | Gross | Histology | Immunohistochemistry | Imaging | Metastasis | ||
Papilloma[3] | Squamous cell papilloma |
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Glandular papilloma |
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Adenoma[4] | Alveolar adenoma |
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Papillary adenoma[5] |
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Mucinous cystadenoma |
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Malignant Lung Tumors[6] | ||||||||||
Variants of lung carcinoma | Risk Factors/Epidemiology | Pleuripotent cell | Topography | Gross | Histology | Immunohistochemistry | Imaging | Metastasis | ||
Squamous cell carcinoma (SCC)[7] | 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[8] |
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Adenocarcinoma[9][10][11] | Acinar adenocarcinoma |
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Aerogenous spread is characteristic
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Papillary adenocarcinoma |
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Bronchio-alveolar carcinoma | Non-mucinous | |||||||||
Mucinous |
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Mixed non-mucinous and mucinous or indeterminate | ||||||||||
Solid adenocarcinoma with mucin production | Fetal adenocarcinoma |
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Mucinous (“colloid”) carcinoma |
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Mucinous cystadenocarcinoma |
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Signet ring adenocarcinoma | ||||||||||
Clear cell adenocarcinoma | ||||||||||
Large cell carcinoma[12] | Basaloid large cell carcinoma of the lung |
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Clear cell carcinoma of the lung | ||||||||||
Lymphoepithelioma-like carcinoma of the lung |
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Large-cell lung carcinoma with rhabdoid phenotype |
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Mixed type |
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Sarcomatoid carcinoma[13] | Carcinosarcoma |
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Spindle cell carcinoma |
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Giant cell carcinoma |
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Pleomorphic carcinoma |
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Pulmonary blastoma |
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Carcinoid tumor[14] | Typical carcinoid
Atypical carcinoid |
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Salivary gland tumors[15] | Mucoepidermoid carcinoma |
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Adenoid cystic carcinoma |
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Epithelial-myoepithelial carcinoma |
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Preinvasive lesions[16] | Squamous carcinoma in situ |
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Atypical adenomatous hyperplasia |
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Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia |
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Mesenchymal tumors[17] | Epithelioid haemangioendothelioma / Angiosarcoma |
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Pleuropulmonary blastoma |
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Chondroma |
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Congenital peribronchial myofibroblastic tumor |
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Diffuse pulmonary lymphangiomatosis |
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Inflammatory myofibroblastic tumor |
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Pulmonary artery sarcoma |
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Pulmonary vein sarcoma |
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Differentiation of lung cancer from other diseases with similar presentation
The following table summarizes the differentiation of lung cancer from other disease entities with similar presentation.[18][19][20][21][22]
Disease | Clinical features
Signs & symptoms |
Radiological Findings | Characterstic feature | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Fever | Cough | Hemoptysis | Dyspnea | Chest pain | Weight loss | Night sweats | |||||
High-grade | Low grade | Productive | Dry | ||||||||
Acute Lung abscess | + | - | + | - | - | - | + | - | - |
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|
Malignancy | - | + | - | + | + | - | - | + | + |
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|
Pulmonary Tuberculosis | + | - | + | - | + | - | - | - | + |
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Necrotizing Pneumonia | + | - | + | + | - | + | - | - |
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| |
Empyema | + | - | + | - | + | + | + | - | - |
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Bronchiectasis | - | - | + | - | + | - | - | - | - |
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|
Wegners granulomatosis | - | - | + | + | + | - | - | - |
| ||
Sarcoidosis | + | - | + | - | + | - | - | + | + |
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|
Rheumatoid nodule | - | - | - | - | - | + | - | + | - |
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|
Langerhans cell Histiocytosis | - | - | - | - | - | + | + | + | - |
|
|
Bronchiolitis obliterans | - | - | + | - | + | + | + | - | - |
|
|
References
- ↑ Erasmus JJ, Connolly JE, McAdams HP, Roggli VL (2000). "Solitary pulmonary nodules: Part I. Morphologic evaluation for differentiation of benign and malignant lesions". Radiographics. 20 (1): 43–58. doi:10.1148/radiographics.20.1.g00ja0343. PMID 10682770.
- ↑ Gümüştaş S, Inan N, Akansel G, Ciftçi E, Demirci A, Ozkara SK (June 2012). "Differentiation of malignant and benign lung lesions with diffusion-weighted MR imaging". Radiol Oncol. 46 (2): 106–13. doi:10.2478/v10019-012-0021-3. PMC 3472932. PMID 23077446.
- ↑ Maxwell RJ, Gibbons JR, O'Hara MD (January 1985). "Solitary squamous papilloma of the bronchus". Thorax. 40 (1): 68–71. PMC 459982. PMID 3969658.
- ↑ Shiota Y, Matsumoto H, Sasaki N, Taniyama K, Hashimoto S, Sueishi K (1998). "Solitary bronchioloalveolar adenoma of the lung". Respiration. 65 (6): 483–5. doi:10.1159/000029319. PMID 9817965.
- ↑ Kanchustambham V, Saladi S, Patolia S, Mahmoud Assaf S, Stoeckel D (March 2017). "A Rare Case of a Benign Primary Pleomorphic Adenoma of the Lung". Cureus. 9 (3): e1069. doi:10.7759/cureus.1069. PMC 5375953. PMID 28409070.
- ↑ Kelley LC, Puette M, Langheinrich KA, King B (November 1994). "Bovine pulmonary blastomas: histomorphologic description and immunohistochemistry". Vet. Pathol. 31 (6): 658–62. doi:10.1177/030098589403100605. PMID 7863581.
- ↑ Roth E, Smidt D (January 1970). "[Studies on early ejaculate collection using electroejaculation in German improved land-swines and Goettinger miniature pigs]". Berl. Munch. Tierarztl. Wochenschr. (in German). 83 (1): 7–11. PMID 5528918.
- ↑ Jackman DM, Johnson BE (2005). "Small-cell lung cancer". Lancet. 366 (9494): 1385–96. doi:10.1016/S0140-6736(05)67569-1. PMID 16226617.
- ↑ Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson. "Chapter 13, box on morphology of adenocarcinoma". Robbins Basic Pathology (8th ed.). Philadelphia: Saunders. ISBN 1-4160-2973-7.
- ↑ Soda M, Choi YL, Enomoto M, Takada S, Yamashita Y, Ishikawa S; et al. (2007). "Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer". Nature. 448 (7153): 561–6. doi:10.1038/nature05945. PMID 17625570.
- ↑ Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg
- ↑ Rossi G, Mengoli MC, Cavazza A, Nicoli D, Barbareschi M, Cantaloni C, Papotti M, Tironi A, Graziano P, Paci M, Stefani A, Migaldi M, Sartori G, Pelosi G (January 2014). "Large cell carcinoma of the lung: clinically oriented classification integrating immunohistochemistry and molecular biology". Virchows Arch. 464 (1): 61–8. doi:10.1007/s00428-013-1501-6. PMID 24221342.
- ↑ Huang SY, Shen SJ, Li XY (October 2013). "Pulmonary sarcomatoid carcinoma: a clinicopathologic study and prognostic analysis of 51 cases". World J Surg Oncol. 11: 252. doi:10.1186/1477-7819-11-252. PMC 3850921. PMID 24088577.
- ↑ Dahabreh J, Stathopoulos GP, Koutantos J, Rigatos S (March 2009). "Lung carcinoid tumor biology: treatment and survival". Oncol. Rep. 21 (3): 757–60. PMID 19212636.
- ↑ Elnayal A, Moran CA, Fox PS, Mawlawi O, Swisher SG, Marom EM (July 2013). "Primary salivary gland-type lung cancer: imaging and clinical predictors of outcome". AJR Am J Roentgenol. 201 (1): W57–63. doi:10.2214/AJR.12.9579. PMC 3767141. PMID 23789697.
- ↑ Greenberg AK, Yee H, Rom WN (2002). "Preneoplastic lesions of the lung". Respir. Res. 3: 20. PMC 107849. PMID 11980589.
- ↑ Koenigkam-Santos M, Sommer G, Puderbach M, Safi S, Schnabel PA, Kauczor HU, Heussel CP (April 2014). "Primary intrathoracic malignant mesenchymal tumours: computed tomography features of a rare group of chest neoplasms". Insights Imaging. 5 (2): 237–44. doi:10.1007/s13244-013-0306-0. PMC 3999366. PMID 24407922.
- ↑ Chaudhuri MR (1973). "Primary pulmonary cavitating carcinomas". Thorax. 28 (3): 354–66. PMC 470041. PMID 4353362.
- ↑ Mouroux J, Padovani B, Elkaïm D, Richelme H (1996). "Should cavitated bronchopulmonary cancers be considered a separate entity?". Ann. Thorac. Surg. 61 (2): 530–2. doi:10.1016/0003-4975(95)00973-6. PMID 8572761.
- ↑ Langford CA, Hoffman GS (1999). "Rare diseases.3: Wegener's granulomatosis". Thorax. 54 (7): 629–37. PMC 1745525. PMID 10377211.
- ↑ Langford CA, Hoffman GS (1999). "Rare diseases.3: Wegener's granulomatosis". Thorax. 54 (7): 629–37. PMC 1745525. PMID 10377211.
- ↑ Suri HS, Yi ES, Nowakowski GS, Vassallo R (2012). "Pulmonary langerhans cell histiocytosis". Orphanet J Rare Dis. 7: 16. doi:10.1186/1750-1172-7-16. PMC 3342091. PMID 22429393.