Diagnostic Pathology of Lung Cancer

In the past 5 years, there has arguably been a shift in the pathologic diagnosis of lung cancer, especially adenocarcinoma, moving toward a more patient-centered approach to reporting that works to incorporate information that may be clinically meaningful to prognosis and impactful to clinical management strategy. As the demand for specialty team care surges, the need for effective communication between specialties continues to increase, particularly to ensure that we are all speaking the same language with regard to diagnostic certainty and the implementation of new terminology. This review of lung cancer pathology is not all-inclusive; but rather, in addition to providing salient histologic and immunohistochemical features of selected topics in adenocarcinoma, squamous cell carcinoma, neuroendocrine tumors, and large cell carcinoma, it also attempts to highlight problems in cancer diagnosis from the pathologist's perspective, including addressing variations in interobserver agreement and limitations to the diagnostic process with regard to immunohistochemistry. In the end, many times, problematic cases might reach resolution not through the narrow-sighted ocular of pathology, but rather through employment of a multidisciplinary approach.