Lung mass pathophysiology

Lung Mass Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief:

Overview

A lung mass is defined as an opacity in the lungs that is more than 3 cms (or 1 ½ inches) in size. Lung opacity less than 3 cms are classified as lung nodules.

Genetics

EGFR mutations are seen in about 20%- 50% of lung adenocarcinoma (especially in Asian population)

• EGFR mutations are responsible for the constitutive activation of the tyrosine kinase.
• The most frequent mutations are present in exons 18e21 of the EGFR gene.
  • Other mutation involves translocations involving the anaplastic lymphoma kinase (ALK) tyrosine kinase are most frequently EML4-ALK fusions and are seen in estimated 10% of patients with lung adenocarcinoma.

• Genes involved in the pathogenesis of Non Small Cell Carcinoma (NSCC) include mutation in ROS1 gene.
  • In Non Small Cell Carcinoma (NSCC), genetic translocations leads to activation of ROS1 gene.
  • ROS1 is a receptor tyrosine kinase of the insulin receptor family.
• Other genes involved in pathogenesis of Non Small Cell Carcinoma (NSCC) include mutation in Her2 (ERBB2), BRAF mutations, MET and RET abnormalities.

Gross Pathology

Cross section of a human lung. The white area in the upper lobe is cancer; the black areas indicate the patient was a smoker