Pulmonary enteric adenocarcinoma: a study of the clinicopathologic and molecular status of nine cases.
Pulmonary enteric adenocarcinoma (PEAC), a extremely rare variant of primary invasive adenocarcinoma of the lung, was recognized by the international multidisciplinary classification of lung adenocarcinoma which was proposed by the International Association for the Study of Lung Cancer (IASLC), the American Thoracic Society (ATS), and the European Respiratory Society (ERS) published in early 2011. Histologically, PEAC is considered to be mainly composed of tall columnar cells arranged in an irregular glandular cavity or cribriform pattern with extensive central necrosis which show high resemblance to that of intestinal epithelia and colorectal carcinomas. Immunohistochemically, PEAC can not only expresses typical proteins common to lung primaries but is positive for at least one intestinal markers, such as CDX2, cytokeratin (CK) 20, MUC2, therefore, the differentiation of primary PEACs from metastatic colorectal cancers can be challenging. In this study, we report 9 cases of PEAC and a panel of immunohistochemical protein markers of CK7, CK20, thyroid transcription factor 1 (TTF-1), Napsin A, MUC2 and villin was analyzed with the comparison of 20 metastatic colorectal carcinomas (MCRs), and 20 typical primary adenocarcinomas (tPACs). As was expected, CK7 expression was documented in all 9 PEACs and 20 tPCAs while CK20 was significantly more prevalent in adenocarcinoma that originated from colorectal. Additionally, we evaluate the classical mutations of EGFR, KRAS in the 9 cases of PEACs, it turned out that all tumors were EGFR-wild and KRAS-wild types, which confirmed that PEAC has a separate phenotype from usual pulmonary adenocarcinoma.
Department of Pathology, Clinical School of Medical College of Nanjing University, Nanjing Jingling Hospital Nanjing, China.
Cai-Xia
CX
Wang
Department of Pathology, Clinical School of Medical College of Nanjing University, Nanjing Jingling Hospital Nanjing, China.
Biao
B
Liu
Department of Pathology, Clinical School of Medical College of Nanjing University, Nanjing Jingling Hospital Nanjing, China.
Yan-Fen
YF
Wang
Department of Pathology, Clinical School of Medical College of Nanjing University, Nanjing Jingling Hospital Nanjing, China.
Ru-Song
RS
Zhang
Department of Pathology, Clinical School of Medical College of Nanjing University, Nanjing Jingling Hospital Nanjing, China.
Bo
B
Yu
Department of Pathology, Clinical School of Medical College of Nanjing University, Nanjing Jingling Hospital Nanjing, China.
Zhen-Feng
ZF
Lu
Department of Pathology, Clinical School of Medical College of Nanjing University, Nanjing Jingling Hospital Nanjing, China.
Qun-Li
QL
Shi
Department of Pathology, Clinical School of Medical College of Nanjing University, Nanjing Jingling Hospital Nanjing, China.
Xiao-Jun
XJ
Zhou
D000230:Adenocarcinoma / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D004252:DNA Mutational Analysis; D005260:Female; D018773:Genes, erbB-1 / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011518:Proto-Oncogene Proteins / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D060888:Real-Time Polymerase Chain Reaction; D018631:ras Proteins / Q000235:genetics
D014408:Biomarkers, Tumor; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins
EGFR/KRAS mutations; Pulmonary adenocarcinoma; clinicopathologic features; enteric; immunohistochemistry