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Related Concept Videos

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Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
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Next Generation Sequencing for the Detection of Actionable Mutations in Solid and Liquid Tumors
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Synchronous Pulmonary Adenocarcinomas.

Carlos A Pagan1, Catherine A Shu2, John P Crapanzano1

  • 1Department of Pathology and Cell Biology, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, NY.

American Journal of Clinical Pathology
|March 9, 2020
PubMed
Summary
This summary is machine-generated.

Molecular testing (MT) shows discordance with histology in synchronous pulmonary carcinomas. Comprehensive molecular review (CMR) using next-generation sequencing (NGS) is crucial for assessing related mutations.

Keywords:
Lung adenocarcinomaMolecularMultipleNext-generation sequencingSynchronous

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Area of Science:

  • Pulmonary pathology
  • Molecular diagnostics
  • Cancer genomics

Background:

  • Synchronous pulmonary carcinomas present diagnostic challenges.
  • Accurate molecular testing (MT) is vital for precise tumor classification and staging.
  • Next-generation sequencing (NGS) offers advanced molecular profiling capabilities.

Purpose of the Study:

  • To evaluate concordance between morphology and MT in synchronous pulmonary carcinomas.
  • To compare targeted NGS with and without comprehensive molecular review (CMR) against single-gene analyses.
  • To assess the utility of MT in staging synchronous tumors.

Main Methods:

  • Analysis of 47 cases with 108 synchronous tumors.
  • Molecular testing performed using targeted NGS (23 cases) and non-NGS (24 cases).
  • Classification of concordance, discordance, or indeterminacy; comprehensive histologic assessment (CHA) for discordant cases.

Main Results:

  • Histology and MT concordance was 53%, discordance 21%, and indeterminacy 26%.
  • Comprehensive histologic assessment (CHA) revised results in 3 of 10 discordant cases.
  • Molecular testing provides an objective surrogate for staging synchronous tumors.

Conclusions:

  • Discordance between histology and MT exists in a subset of synchronous pulmonary carcinomas.
  • A limited gene panel suffices for assessing distinct driver mutations.
  • CMR with a larger NGS panel is necessary for evaluating related mutations.