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Pulmonary squamous cell carcinoma with a lepidic-pagetoid growth pattern
Claudio Guerrieri1, Mark Lindner2, Joanna Sesti3
1Department of Pathology, Immunology and Molecular Pathology, Rutgers New Jersey Medical School, Newark, NJ.
Pathologica
|September 22, 2022
Summary
This study describes a rare lung squamous cell carcinoma (SCC) with lepidic and pagetoid growth patterns. Current staging may need revision to include these non-invasive components for accurate lung cancer classification.
Area of Science:
- Pulmonology
- Oncology
- Pathology
Background:
- Squamous cell carcinoma (SCC) is a common type of lung cancer.
- Accurate pathological staging is crucial for lung cancer treatment and prognosis.
Observation:
- A rare peripheral lung SCC exhibited predominantly lepidic and pagetoid growth patterns.
- Tumor cells showed positivity for squamous markers p63 and p40.
- Immunohistochemistry revealed specific staining patterns for tumor and non-neoplastic cells.
Findings:
- The tumor displayed extensive non-invasive lepidic and pagetoid spread.
- Despite a small invasive component (2.5 mm), the overall tumor size was 9.0 mm.
- Current staging criteria classified it as pT1a, not fully reflecting the tumor's extent.
Implications:
- The lepidic component in pulmonary SCC is not adequately addressed by current staging systems.
- Revising lung carcinoma classification and pathological staging may be necessary to incorporate this growth pattern.
- Increased awareness of this variant could improve diagnostic accuracy and patient management.
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