title: [Clinicopathological characteristics and imaging features of pulmonary adenocarcinoma with micropapillary pattern].
abstract: OBJECTIVE
  To explore the clinicopathological characteristics and imaging features of lung adenocarcinoma with a micropapillary pattern (MPP).
  
  
  METHODS
  Eighty cases of pulmonary adenocarcinoma with a micropapillary pattern treated in our hospital from July 2011 to December 2012 were selected to retrospectively analyze their clinicopathological characteristics and imaging features.
  
  
  RESULTS
  Among the 80 cases of lung adenocarcinoma with MPP, there were 38 cases of stage I (47.5%), 12 cases of stage II (15.0%), 25 cases of stage III (31.3%) and 5 cases of stage IV (6.2%). There were 14 cases of moderately differentiated (17.5%) and moderately/poorly differentiated (82.5%) tumors. Sixty-three cases had pleural involvement, vascular invasion, involving the bronchial wall, invasion of large vessels, nerve invasion, and lymph node metastasis (at least one of them) (78.8%). Immunohistochemical staining revealed that both positive rates of TTF-1 and CK7 were 100%, and that of pulmonary surfactant apolipoprotein-A (SPA) was 84.0%. Imaging examination revealed hilar or mediastinal lymph node enlargement in 15 cases (18.8%). but the pathology confirmed hilar or mediastinal lymph node metastasis in 36 cases (45.0%). Lung CT imaging showed that the majority of the cases were peripheral type, and only a few of central type, and most cases were solid lesions, with lobulation, spiculation, pleural indentation, and vascular convergence sign, while there were few ground-glass opacity sign and vacuole sign.
  
  
  CONCLUSIONS
  Lung adenocarcinoma with MPP component often presents with early invasions of pleura, blood vessels, lymphatic vessels, and lymph nodes. Imaging manifestation of this cancer mainly shows as peripheral and solid lesions, often with lobulation, spiculation, pleural indentation, vascular convergence sign, but GGO and vacuole signs are unusual. Overexpression of TTF-1, CK7 and SPA, and elevated CEA level are associated with clinical staging of the disease.
authors.affiliation: Department of Respiratory Medicine, the First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Jianfei
authors.initials: J
authors.lastname: Ren
authors.forename: Jianya
authors.initials: J
authors.lastname: Zhou
authors.forename: Wei
authors.initials: W
authors.lastname: Ding
authors.forename: Baishu
authors.initials: B
authors.lastname: Zhong
authors.affiliation: Email: zjyhz@zju.edu.cn.
authors.forename: Jianying
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001054:Apolipoproteins A / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D004268:DNA-Binding Proteins / Q000378:metabolism; D005260:Female; D006801:Humans; D053552:Keratin-7 / Q000378:metabolism; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014157:Transcription Factors
chemical_list: D001054:Apolipoproteins A; D002272:Carcinoembryonic Antigen; D004268:DNA-Binding Proteins; D053552:Keratin-7; C504003:TTF1 protein, human; D014157:Transcription Factors