Abstract
The diagnosis of malignant lung tumors on a small biopsy or on cytologic material is one of the most crucial tasks in the daily practice of pathology. The lung is difficult to sample as it is mobile with respiration and a vascular organ with liability to bleeding and puncture resulting in pneumothorax. Small material is the norm in the initial evaluation of nodules and masses, and the differential diagnosis is wide and varied. The integration of clinical and radiological findings becomes more crucial in the approach to a final and accurate diagnosis. It is important to be accurate but also to be helpful in narrowing the differential diagnosis whenever possible.
The introduction of targeted therapy added a new demand on pathologists to do more with less. Currently pathologists are asked to be specific in diagnosing adenocarcinoma and procuring tissue for molecular testing in addition to immunohistochemical studies.
Neuroendocrine tumors constitute an important group in the lung with their wide spectrum and overlapping features among themselves as a group but with other tumors of non-neuroendocrine derivation such as basaloid squamous cell carcinoma and those with partial neuroendocrine differentiation such as large cell neuroendocrine carcinoma.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger KR, Yatabe Y, et al. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6(2):244–85.
Austin JH, Garg K, Aberle D, Yankelevitz D, Kuriyama K, Lee HJ, et al. Radiologic implications of the 2011 classification of adenocarcinoma of the lung. Radiology. 2013;266(1):62–71.
Ichinokawa H, Ishii G, Nagai K, Kawase A, Yoshida J, Nishimura M, et al. Distinct clinicopathologic characteristics of lung mucinous adenocarcinoma with KRAS mutation. Hum Pathol. 2013;44(12):2636–42.
Saad RS, Cho P, Silverman JF, Liu Y. Usefulness of Cdx2 in separating mucinous bronchioloalveolar adenocarcinoma of the lung from metastatic mucinous colorectal adenocarcinoma. Am J Clin Pathol. 2004;122(3):421–7.
Travis WD, Rekhtman N. Pathological diagnosis and classification of lung cancer in small biopsies and cytology: strategic management of tissue for molecular testing. Semin Respir Crit Care Med. 2011;32(1):22–31.
Bishop JA, Sharma R, Illei PB. Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma. Hum Pathol. 2010;41(1):20–5.
Bishop JA, Teruya-Feldstein J, Westra WH, Pelosi G, Travis WD, Rekhtman N. p40 (DeltaNp63) is superior to p63 for the diagnosis of pulmonary squamous cell carcinoma. Mod Pathol. 2012;25(3):405–15.
Paez JG, Janne PA, Lee JC, Tracy S, Greulich H, Gabriel S, et al. EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science. 2004;304(5676):1497–500.
Zakowski MF. Pathology of small cell carcinoma of the lung. Semin Oncol. 2003;30(1):3–8.
Jiang SX, Kameya T, Shoji M, Dobashi Y, Shinada J, Yoshimura H. Large cell neuroendocrine carcinoma of the lung: a histologic and immunohistochemical study of 22 cases. Am J Surg Pathol. 1998;22(5):526–37.
Sholl LM. Large-cell carcinoma of the lung: a diagnostic category redefined by immunohistochemistry and genomics. Curr Opin Pulm Med. 2014;20(4):324–31.
Travis WD, Rush W, Flieder DB, Falk R, Fleming MV, Gal AA, et al. Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol. 1998;22(8):934–44.
Watanabe R, Ito I, Kenmotsu H, Endo M, Yamamoto N, Ohde Y, et al. Large cell neuroendocrine carcinoma of the lung: is it possible to diagnose from biopsy specimens? Jpn J Clin Oncol. 2013;43(3):294–304.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Fraig, M.M. (2015). Malignant Tumors of the Lung in Small Lung Biopsies. In: Fraig, M. (eds) Diagnosis of Small Lung Biopsy. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2575-9_8
Download citation
DOI: https://doi.org/10.1007/978-1-4939-2575-9_8
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-2574-2
Online ISBN: 978-1-4939-2575-9
eBook Packages: MedicineMedicine (R0)