Morphologic Features of Invasion in Lung Adenocarcinoma: Diagnostic Pitfalls
ADVANCES IN ANATOMIC PATHOLOGY(2024)
Abstract
Reproducibility of pulmonary invasive adenocarcinoma diagnosis is poor when applying the World Health Organization (WHO) classification. In this article, we aimed first to explain by 3-dimensional morphology why simple pattern recognition induces pitfalls for the assessment of invasion as applied in the current WHO classification of pulmonary adenocarcinomas. The underlying iatrogenic-induced morphologic alterations in collapsed adenocarcinoma in situ overlap with criteria for invasive adenocarcinoma. Pitfalls in seemingly acinar and papillary carcinoma are addressed with additional cytokeratin 7 and elastin stains. In addition, we provide more stringent criteria for a better reproducible and likely generalizable classification.
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Key words
Lung,adenocarcinoma,invasion,morphology,adenocarcinoma in situ,elastin,cytokeratin 7
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