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1000 Titel
  • Prominent entrapment of respiratory epithelium in primary and metastatic intrapulmonary non-epithelial neoplasms: a frequent morphological pattern closely mimicking adenofibroma and other biphasic pulmonary lesions
1000 Autor/in
  1. Erber, Ramona |
  2. Haller, Florian |
  3. Hartmann, Arndt |
  4. Agaimy, Abbas |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-03-19
1000 Erschienen in
1000 Quellenangabe
  • 477(2):195-205
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00428-020-02796-7 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371666/ |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • As one of the most common target organs for hematogenous spread from diverse cancers, biopsy interpretation of lung tumors is complicated by the challenging question of primary versus metastatic and by frequent entrapment of native respiratory glands. Nevertheless, the literature dealing with this issue is surprisingly sparse and no single study has been devoted to this topic. We reviewed 47 surgical lung specimens of non-epithelial neoplasms (38 metastases, mainly from sarcomas and 9 primary lesions) for frequency and pattern of intralesional epithelial entrapment. Respiratory epithelium entrapment was noted in 23/47 (49%) cases (diffuse in 15 and peripheral in 8). Entrapped glands frequently showed prominent regenerative and reactive changes mimicking neoplastic glands. Based on cellularity of the mesenchymal component and the extent, distribution and shape of entrapped respiratory glands, four morphological patterns were recognized: paucicellular sclerosing low-grade neoplasms containing leaflet-like glands indistinguishable from adenofibroma and fibroepithelial hamartomas (n = 11), and biphasic cellular lesions mimicking adenomyoepithelioma (n = 1), biphasic synovial sarcoma (n = 2), and pleuropulmonary blastoma (n = 1). Only a single genuine pulmonary adenofibroma was identified. This study highlights frequent respiratory epithelium entrapment in diverse non-epithelial lung tumors, both primary and metastatic. Recognition of this finding and use of adjunct IHC combined with clinical history should help to avoid misinterpretation as primary pulmonary biphasic neoplasm or as harmless adenofibroma. The vast majority of morphologically defined lung adenofibromas represent adenofibroma-like variants of histogenetically diverse entities so that a diagnosis of adenofibroma should be rendered only very restrictively and then as a diagnosis by exclusion.
1000 Sacherschließung
lokal Aged [MeSH]
lokal Lung Neoplasms/diagnosis [MeSH]
lokal Adenomyoepithelioma
lokal Diagnosis, Differential [MeSH]
lokal Original Article
lokal Male [MeSH]
lokal Germ cell tumor
lokal Biomarkers, Tumor/analysis [MeSH]
lokal Adenofibroma/diagnosis [MeSH]
lokal Adolescent [MeSH]
lokal Female [MeSH]
lokal Respiratory Mucosa/pathology [MeSH]
lokal Adult [MeSH]
lokal Osteosarcoma
lokal Sarcoma
lokal Humans [MeSH]
lokal Neoplasm Metastasis [MeSH]
lokal Adenofibroma
lokal Middle Aged [MeSH]
lokal Lung
lokal Hamartoma
lokal Adenofibroma/pathology [MeSH]
lokal Lung metastasis
lokal Young Adult [MeSH]
lokal Lung Neoplasms/pathology [MeSH]
lokal Nephroblastoma
lokal Fibroadenoma
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