A Study On Lung Cancer

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Introduction: Lung cancers are well known to display inter and intra-tumoral heterogeneity with profound implications for exact histological classification by pathologists1–3. The New International (IASLC/ATS/ERS )4,5 and the 2015 World Health Organization (WHO) classification6 has defined the non-invasive (adenocarcinoma in situ), minimally invasive adenocarcinoma and invasive lepidic adenocarcinoma ; has replaced the 'mixed subtype category ' in the WHO 2004 classification7 with the predominant subtype ; included the micropapillary subtype8,9 and replaced the term “mucinous bronchioloalveolar carcinoma(BAC)” with invasive mucinous adenocarcinoma. This study aimed to do a comprehensive histological subtyping and detailed study of …show more content…

Amongst 237 cases, a significant proportion 195(82.2%) were at stage IV at diagnosis, fewer 31(13.5%) at stage III and 11(4.7%) at Stage II and none at Stage I.

Histologic findings:
The 2015 WHO classification of lung tumours (add ref) was used to categorise biopsies by the predominant histological subtype. Of 274 cases, 167 (61%) were acinar predominant adenocarcinomas, 63(23%) solid adenocarcinomas, 19 (7%) invasive mucinous adenocarcinomas, 11(4%)lepidic predominant, papillary 9 (3.30%), two cases each of colloid (0.7%) and non- small cell carcinoma, not otherwise specified (NSCC-NOS) (0.7%) and one micro-papillary predominant subtype (0.3%) (Figure 1; Figures 2A-2D; Figures 3A-3D).
The polygonal cell type was the most frequent comprising 160(58.40%) followed by columnar 69(25.2%), cuboidal 38(13.9%), signet ring 4(1.4%), hobnail 2 (0.7%) and clear cell 1(0.4%) cell types. A significant percentage of tumours were associated with mucin production, desmoplasia, stromal elastosis, lympho-vascular invasion and necrosis (Table 1). Lymphovascular invasion was most commonly seen amongst stage III/ stage IV disease in 187/226 (82.7%). The majority of tumours, 213/263 (81%) were TTF-1 positive. Almost all cases, 134/135 (99.3%) demonstrated positivity for CK7 and Ber-EP4 63/65 (97%).

Correlation of histologic subtypes with clinical features:
The papillary subtype in 7/7 (100%) followed by the lepidic predominant in 4/5(80%), acinar in 75/102

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