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Lung adenocarcinomas with micropapillary components
Ryo Maeda1, Noritaka Isowa, Hideyuki Onuma
1Division of Thoracic Surgery, Matsue Red Cross Hospital, Matsue, Shimane, Japan. ryomaedamatsue@yahoo.co.jp
Purpose:
Micropapillary adenocarcinoma is becoming increasingly recognized as a prognostically important histological subtype of carcinoma in various organs. This report presents the clinicopathological findings of lung adenocarcinomas with micropapillary components.
Methods:
A total of 15 patients with micropapillary components were selected between April 2005 and December 2008. The results of their clinical presentation, metastasis to lymph nodes, pleural invasion, pathological stage, and clinical outcomes were evaluated.
Results:
In all, 12 patients underwent a lobectomy or bilobectomy with a regional lymph node dissection; 8 showed metastases to the regional lymph nodes at the time of the operation. Altogether, 14 of 15 cases showed lymphovascular invasion; 10 cases were up-staged after the operation because of lymph node metastases or pleural invasion. The duration of follow-up ranged from 1 to 42 months (median 16 months). Seven patients are alive without disease, whereas seven are alive with disease and one patient died of disease.
Conclusion:
These results suggest that the micropapillary components are a manifestation of aggressive behavior, as shown by the frequent lymph node metastases and pleural invasion. Surgeons should search more carefully for metastases and conduct a closer follow-up on these patients when this feature is present with lung adenocarcinoma.
Insights
Micropapillary adenocarcinoma in lung cancer indicates aggressive behavior, often leading to lymph node metastasis and pleural invasion. Closer monitoring and surgical evaluation are recommended for patients with this histological subtype.
Area of Science:
- Oncology
- Pathology
Background:
- Micropapillary adenocarcinoma is an increasingly recognized histological subtype.
- It holds prognostic importance across various carcinomas.
Purpose of the Study:
- To present clinicopathological findings of lung adenocarcinomas with micropapillary components.
- To evaluate the clinical significance of micropapillary features in lung adenocarcinoma.
Main Methods:
- Retrospective analysis of 15 patients with micropapillary components (April 2005 - December 2008).
- Evaluation of clinical presentation, lymph node metastasis, pleural invasion, pathological stage, and outcomes.
- Surgical procedures included lobectomy or bilobectomy with lymph node dissection.
Main Results:
- 8 out of 12 patients undergoing surgery showed lymph node metastases.
- 14 out of 15 cases exhibited lymphovascular invasion.
- 10 cases were up-staged due to lymph node metastases or pleural invasion.
- Follow-up ranged from 1 to 42 months (median 16 months).
- 7 patients were alive without disease, 7 alive with disease, and 1 died of disease.
Conclusions:
- Micropapillary components signify aggressive behavior in lung adenocarcinoma.
- Frequent lymph node metastases and pleural invasion are associated with this subtype.
- Recommendations include careful search for metastases and closer patient follow-up.
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