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Tumors of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Meningeal metastases; the most common primary malignancies are: Adenocarcinoma of the lung, breast, and gastrointestinal tract.Melanoma.Leukemia and lymphoma.
The Many Faces of Neoplasia
Published in Jeremy R. Jass, Understanding Pathology, 2020
The histogenetic classification provides more than a mere categorisation of cancer. It groups cancers into types that differ in terms of their causation, presentation, treatment and outcome. For example, it could be said that lung cancer is caused by smoking. This is virtually always true for squamous cell carcinoma, but less so for adenocarcinoma of the lung which is caused by other factors also. There is a third category of lung cancer called oat cell carcinoma (see below), which tends to disseminate widely so that surgery is attempted in a minority of cases only. Most patients with oat cell carcinoma of the lung die within a year of diagnosis, whereas the other lung cancers may be cured by surgery. Thus, the term lung cancer or carcinoma is not a complete diagnosis. The range of cancers occurring within each organ or system is large and coverage goes beyond the scope of this book (Fletcher, 1996).
The Lung and the Pleura
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Adenocarcinoma of the lung has shown an increase in the incidence in the past decade. These tumors are usually located in the periphery of the lung, usually accompanied by a scar and they may cause some thickening in the pleural. They have the least yield in sputum cytology. These tumors invade the small peripheral bronchi secondarily, and as a general rule, metastasize early to the lymph nodes. Exception to this rule is the true bronchioalveolar carcinoma that tends to reach large size before invading the pleural or metastasizing to the lymph nodes. It is sometimes very difficult to differentiate primary carcinoma from metastatic carcinoma to the lung.
A profile on cobas® EGFR Mutation Test v2 as companion diagnostic for first-line treatment of patients with non-small cell lung cancer
Published in Expert Review of Molecular Diagnostics, 2020
Susana Torres, Álvaro González, Alberto Jacobo Cunquero Tomas, Silvia Calabuig Fariñas, Macarena Ferrero, Danielle Mirda, Rafael Sirera, Eloisa Jantus-Lewintre, Carlos Camps
Several prospective randomized clinical trials demonstrated that EGFR-mutated NSCLC patients in advanced stages had better outcome when treated with specific EGFR-TKIs in first-line [39,47]. Therefore, timely EGFR-mutation testing at diagnosis in all patients with advanced adenocarcinoma of the lung is mandatory. Tumor tissue biomarker analysis in different samples is still considered the gold standard for this purpose. Detection techniques used for EGFR-mutation assessment should be able to detect mutations when the tumor cellular content comprises as low as 10% of the total specimen [48]. Moreover, it is important to remark that in more than 30% of advanced NSCLC patients, tumor genotyping is not feasible. In this scenario, cfDNA analysis is an attractive and established alternative for testing EGFR-sensitizing mutations. As explained previously, the cobas® EGFR Mutation Test v2 is a real-time PCR-based test, that allows a reliable and rapid solution for EGFR mutational status assessment at the time of diagnosis in both tissue and plasma samples. It can be used for sensitizing mutations testing with an acceptable sensitivity in tissue-derived DNA and plasma-derived DNA. Nevertheless, some pre-analytical considerations like tumor cell content in tissue samples, tumor burden or location of metastasis, which is related to the shedding behavior of the tumors, should be contemplated for a better understanding and interpretation of results in the clinical practice (Figure 2).
The relevance of bronchoalveolar lavage fluid analysis for lung cancer patients
Published in Expert Review of Respiratory Medicine, 2020
The epithelial tumor cells in the BALF smear present typical features also visible in other liquid samples, including pleural fluid or the fluids of other body cavities. The three-dimensional clusters of the cells are visible. They are different in shape and size with nuclear polymorphism, hyperchromatic nuclei, sometimes nucleoli, with high nuclear/cytoplasmic ratio [31]. The differential diagnosis of epithelial tumors on the basis of cell morphology in the BALF is difficult and almost impossible. Since 2011 the classification of adenocarcinoma of the lung was modified and currently the precise subtyping of adenocarcinoma is possible only using surgery specimens [32,33]. The report from BAL may state only ‘adenocarcinoma’ and IHC permits the more precise diagnosis of the origin of adenocarcinoma [34]. Figure 2 presents examples of useful markers for the differential diagnosis of primary and secondary lung tumors.
Histomorphologic features of lung adenocarcinomas exhibiting ALK gene rearrangement
Published in Baylor University Medical Center Proceedings, 2019
Daniel S. Grosser, Haiying Zhang
Our institution routinely performs a LungSEQ genotyping panel on lung adenocarcinomas, which consists of targeted next-generation sequencing to identify mutations in nine known oncogenes (AKT1, BRAF, EGFR, ERBB2, KRAS, MAP2K1, NRAS, PIK3CA, and PTEN) and a reflex FISH panel designed to detect gene rearrangements in ALK, ROS1, and RET genes. The results of this panel are then reported in addenda to the original pathology reports. We performed a search in our electronic record of pathology reports from January 2015 through September 2017 to locate all cases of lung adenocarcinoma that underwent this panel of testing. We reviewed these reports to identify cases that were found to be positive for ALK rearrangements. The slides from these ALK-rearranged cases were pulled to identify the specific histomorphologic features present in each ALK-rearranged adenocarcinoma of the lung. We also reviewed the results of immunohistochemistry performed in support of the diagnoses in each case.