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Primary Lung Tumors in Children: Radiologic-Pathologic Correlation From the Radiologic Pathology Archives.

John P Lichtenberger1, David M Biko1, Brett W Carter1

  • 1From the Department of Radiology and Radiological Sciences (J.P.L., E.M.C.) and Department of Pathology (J.P.L., A.R.H., E.M.C.), Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; Thoracic Radiology Section (J.P.L., D.M.B.) and Pediatric Radiology Section (D.M.B., E.M.C.), American Institute for Radiologic Pathology, Silver Spring, Md; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (D.M.B.); Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (B.W.C.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (M.A.P.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc
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Pediatric lung tumors are rare but require careful diagnosis. Differentiating features on imaging and pathology, including genetic markers, are crucial for accurate identification and treatment of these childhood cancers.

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Area of Science:

  • Pediatric Oncology
  • Diagnostic Imaging
  • Molecular Pathology

Background:

  • Primary lung tumors in children are uncommon, presenting diverse imaging characteristics.
  • Overlapping appearances necessitate detailed analysis of imaging and pathological features for accurate diagnosis.

Purpose of the Study:

  • To outline key discriminating features for diagnosing primary lung tumors in children.
  • To integrate radiologic and pathologic knowledge for improved diagnostic accuracy and patient management.

Main Methods:

  • Review of imaging findings (e.g., cysts, attenuation) for specific pediatric lung tumors.
  • Analysis of key pathologic and genetic discriminators (e.g., DICER1 mutations, ETV6-NTRK3 fusion).
  • Correlation of imaging characteristics with histological findings and genetic alterations.

Main Results:

  • Specific imaging findings aid in differentiating neonatal/infantile tumors like pleuropulmonary blastoma (PPB) and fetal lung interstitial tumor.
  • Genetic markers (DICER1, ETV6-NTRK3) are critical for distinguishing PPB and infantile fibrosarcoma.
  • Inflammatory myofibroblastic tumors (IMTs) and carcinoid tumors have characteristic imaging and genetic profiles in older children.

Conclusions:

  • Accurate diagnosis of pediatric lung tumors relies on integrating imaging, pathology, and genetic data.
  • Understanding these discriminators is vital for effective treatment planning and surveillance strategies.
  • Continued research into novel imaging agents may enhance diagnostic capabilities for specific tumor types.