Sandbox:Cherry: Difference between revisions
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==Pathogenesis== | ==Pathogenesis== | ||
* This cancer usually is seen peripherally in the lungs, as opposed to [[small cell lung cancer]] and [[squamous cell]] lung cancer, which both tend to be more centrally located.<ref name=Travis95>{{cite journal |author=Travis WD, Travis LB, Devesa SS |title=Lung cancer |journal=Cancer |volume=75 |issue=1 Suppl |pages=191–202 |date=January 1995|pmid=8000996 |doi= 10.1002/1097-0142(19950101)75:1+<191::AID-CNCR2820751307>3.0.CO;2-Y|url=}}</ref><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> | * This cancer usually is seen peripherally in the lungs, as opposed to [[small cell lung cancer]] and [[squamous cell]] lung cancer, which both tend to be more centrally located.<ref name=Travis95>{{cite journal |author=Travis WD, Travis LB, Devesa SS |title=Lung cancer |journal=Cancer |volume=75 |issue=1 Suppl |pages=191–202 |date=January 1995|pmid=8000996 |doi= 10.1002/1097-0142(19950101)75:1+<191::AID-CNCR2820751307>3.0.CO;2-Y|url=}}</ref><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> | ||
Revision as of 17:07, 2 March 2018
Physical examination
Overview
On gross pathology, peripheral multifocal lesions is the characteristic finding of adenocarcinoma of the lung.[1] On microscopic histopathological analysis, nuclear atypia, eccentrically placed nuclei, abundant cytoplasm, and conspicuous nucleoli are characteristic findings of adenocarcinoma of the lung. Genes involved in the pathogenesis of adenocarcinoma of the lung include EGFR, HER2, KRAS, ALK, and BRAF.[2]
Pathogenesis
- This cancer usually is seen peripherally in the lungs, as opposed to small cell lung cancer and squamous cell lung cancer, which both tend to be more centrally located.[3][4]
- Individual susceptibility, active smoking, radon exposure, exposure to high pollution levels, asbestos exposure, occupational or environmental exposure to particular agents or carcinogens. Hydrocarbons cause damage to the DNA and form DNA adducts. Benzo-A-pyrine has effects on inducing p53 mutations and affects molecular signaling pathways such as AKT.
The “multiple hit theory” for adenocarcinoma of the lung states that genetic reproduction is hindered due to the cumulative effect of several toxic insults. Underlying lung disease such as COPD, idiopathic pulmonary fibrosis and tuberculosis may exacerbate the process. Mutations involving the ras family of oncogenes: The ras oncogene family has 3 members: H-ras K-ras, also determines patient prognosis N-ras Mutations of ras affect signal transduction by affecting GTPase activity.They are found in 30 percent of cases.
c-myc c-raf tumor suppressor genes retinoblastoma (Rb) and p53 Mutations of APOBEC protein
Genetics
- EGFR (7p11)
- KRAS (12p12)
- BRAF (7q34)
- PIK3CA (3q26)
- ERBB2 (17q12)
- Translocation EML4/ALK
- Tyrosine kinase fusions
- ALK (2p23), ROS1 (6q22), and RET (10q11)
Gross Pathology
- Peripheral lesions
- May be multifocal
Gallery
-
![his subpleural lesion consists mostly of pigmented scar tissue with gray-tan tumor seen predominantly at the periphery.The visceral pleura overlying the tumor is retracted due to traction by underlying scar tissue. This is a good example of what has been called "scar carcinoma". In almost all cases of this type the scar is not a pre-existing lesion but rather represents a desmoplastic reponse to the tumor cells. The basal visceral pleura is involved by tumor[8]](/images/9/97/Lung_adenocarcinoma1.jpg)
his subpleural lesion consists mostly of pigmented scar tissue with gray-tan tumor seen predominantly at the periphery.The visceral pleura overlying the tumor is retracted due to traction by underlying scar tissue. This is a good example of what has been called "scar carcinoma". In almost all cases of this type the scar is not a pre-existing lesion but rather represents a desmoplastic reponse to the tumor cells. The basal visceral pleura is involved by tumor[8]
![his subpleural lesion consists mostly of pigmented scar tissue with gray-tan tumor seen predominantly at the periphery.The visceral pleura overlying the tumor is retracted due to traction by underlying scar tissue. This is a good example of what has been called "scar carcinoma". In almost all cases of this type the scar is not a pre-existing lesion but rather represents a desmoplastic reponse to the tumor cells. The basal visceral pleura is involved by tumor[8]](/index.php/File:Lung_adenocarcinoma1.jpg)
Microscopic Pathology
- Nuclear atypia
- Eccentrically placed nuclei
- Abundant cytoplasm
- Conspicuous nucleoli
- Nuclear pseudoinclusions
- Lack of intercellular bridges
Subtypes[9]
- Lepidic predominant
- Tumor grows long the alveolar wall
- Acinar predominant
- Berry-shaped glands, smaller than lung acini
- Papillary predominant
- Fibrovascular cores
- Micropapillary predominant
- Nipple shaped projections without fibrovascular cores
- Solid predominant
- Sheet of cells
Gallery
-
![Micrograph of mucinous adenocarcinoma of the lung. H&E stain. [10]](/images/1/13/Lung_adenocarcinoma2.jpg)
Micrograph of mucinous adenocarcinoma of the lung. H&E stain. [10]
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![Micrograph showing an adenocarcinoma of the lung (acinar pattern). H&E stain. [11]](/images/0/03/Lung_adenocarcinoma3.jpg)
Micrograph showing an adenocarcinoma of the lung (acinar pattern). H&E stain. [11]
![Micrograph of mucinous adenocarcinoma of the lung. H&E stain. [10]](/index.php/File:Lung_adenocarcinoma2.jpg)
![Micrograph showing an adenocarcinoma of the lung (acinar pattern). H&E stain. [11]](/index.php/File:Lung_adenocarcinoma3.jpg)
References
- ↑ Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg
- ↑ Stewart, Bernard (2014). World cancer report 2014. Lyon, France Geneva, Switzerland: International Agency for Research on Cancer,Distributed by WHO Press, World Health Organization. ISBN 9283204298.
- ↑ Travis WD, Travis LB, Devesa SS (January 1995). "Lung cancer". Cancer. 75 (1 Suppl): 191–202. doi:10.1002/1097-0142(19950101)75:1+<191::AID-CNCR2820751307>3.0.CO;2-Y. PMID 8000996.
- ↑ 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.
- ↑ Stewart, Bernard (2014). World cancer report 2014. Lyon, France Geneva, Switzerland: International Agency for Research on Cancer,Distributed by WHO Press, World Health Organization. ISBN 9283204298.
- ↑ 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.
- ↑ Davies KD, Le AT, Theodoro MF, Skokan MC, Aisner DL, Berge EM; et al. (2012). "Identifying and targeting ROS1 gene fusions in non-small cell lung cancer". Clin Cancer Res. 18 (17): 4570–9. doi:10.1158/1078-0432.CCR-12-0550. PMC 3703205. PMID 22919003.
- ↑ Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Adenocarcinoma_%283950819000%29.jpg
- ↑ Adenocarcinoma of the lung. Librepathology 2015. http://librepathology.org/wiki/index.php/Adenocarcinoma_of_the_lung#Microscopic Accessed on December 20, 2015
- ↑ Acinar adenocarcinoma. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Mucinous_adenocarcinoma_of_the_lung_--_high_mag.jpg
- ↑ Mucinous adenocarcinoma. Librepathology 2015. http://librepathology.org/wiki/index.php/File:Acinar_pattern_adenocarcinoma_of_lung_--_intermed_mag.jpg
References
Pathophysiology prev
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Cirrhosis Microchapters |
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American Roentgen Ray Society Images of Sandbox:Cherry |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Pathophysiology prev
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Cirrhosis Microchapters |
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Diagnosis |
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Treatment |
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Case studies |
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Sandbox:Cherry On the Web |
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American Roentgen Ray Society Images of Sandbox:Cherry |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief:
History and Symptoms
- History should include:
- Appearance of bowel movements
- Travel history
- Associated symptoms
- Immune status
- Woodland exposure
References
Other Imaging Findings
Other diagnostic studies
Other Diagnostic Studies
- Breath hydrogen test
- HIV testing for those patients suspected of having HIV
==
Overview
References
Pathophysiology prev
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Cirrhosis Microchapters |
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Diagnosis |
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Treatment |
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Case studies |
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Sandbox:Cherry On the Web |
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American Roentgen Ray Society Images of Sandbox:Cherry |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3] Associate Editor(s)-in-Chief:
Video codes
Normal video
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Video in table
Floating video
| Title |
| https://https://www.youtube.com/watch?v=ypYI_lmLD7g%7C350}} |
Redirect
- REDIRECTEsophageal web
synonym website
https://mq.b2i.sg/snow-owl/#!terminology/snomed/10743008
Image
Image to the right
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Image and text to the right
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Gallery
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![Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/images/2/2f/Pancreatic_insulinoma_histology_2.JPG)
Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]
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![Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/images/a/a3/Pancreatic_insulinoma_histopathology_3.JPG)
Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]
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![Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/images/d/d5/Pancreatic_insulinoma_histology_4.JPG)
Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]
![Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/index.php/File:Pancreatic_insulinoma_histology_2.JPG)
![Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/index.php/File:Pancreatic_insulinoma_histopathology_3.JPG)
![Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/index.php/File:Pancreatic_insulinoma_histology_4.JPG)
References
- ↑ 1.0 1.1 1.2 Neuroendocrine tumor of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas
REFERENCES