The 2004 World Health Organization classification of lung tumors

Beasley, Mary Beth; Brambilla, Élisabeth; Travis, William D.

doi:10.1053/j.ro.2005.01.001

Cited by 502 publications

(415 citation statements)

References 86 publications

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“…In 1999, a group named "carcinoma with pleomorphic, sarcomatoid, or sarcomatous elements" was defined. In 2004, this group, which contained pleomorphic carcinoma, was renamed "Sarcomatoid carcinoma" [1]. Travis WD et al had previously reported pleomorphic carcinoma of the lung to be very rare (approximately 0.1 -0.4% of all lung malignancies) [2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…According to the World Health Organization classification of lung tumors, pleomorphic carcinoma of the lung is one of five subgroups of sarcomatoid carcinoma [1], which itself is defined as a group of poorly differentiated tumors characterized pathologically by a combination of epithelial and mesenchymal elements. Pleomorphic carcinoma is histologically defined as either non-small cell carcinoma combined with neoplastic spindle and/or giant cell or a carcinoma that consists of only spindle cell and giant cell.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics of pleomorphic carcinoma of the lung

Ito¹,

Oizumi²,

Fukumoto³

et al. 2010

Lung Cancer

104

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Background: Pleomorphic carcinoma of the lung is a malignant epithelial tumor that contains carcinomatous and sarcomatoid components. Due to its rarity, few studies have been reported, and its clinical and pathological characteristics remain unclear.Method: We retrospectively investigated 22 cases of pleomorphic carcinoma of the lung.Results: Fifteen cases were diagnosed by surgical resection, four by autopsy, and three by transbronchial biopsy. Nineteen patients were male and three were female, and their mean age at diagnosis was 68.3 years (± 10.1).Eighteen were current-or ex-smokers with substantial smoking histories (mean 46.4 pack-years). Sixteen patients had symptoms: hemoptysis and cough were commonly seen. Chest computed tomography (CT) findings revealed that the tumors were quite large (mean diameter 45.3 ± 21.9 mm; range 14-110 mm), and 21 tumors were peripherally located. Positron emission tomography with 18-fluorodeoxy-glucose (FDG-PET) was performed in 12 patients, and the Standardized Uptake Value (SUV) tended to be high (9.44 ± 4.98). In the 15 patients who underwent surgical resection, recurrence was common; systemic metastases were also frequently found. Patients who had received surgical 3 treatment with proper follow-up care survived longer than those who did not undergo surgery. Responses to chemotherapy were generally poor, although one patient exhibited partial response to gefitinib.Conclusions: Pulmonary pleomorphic carcinoma has strong malignant potential with frequent distant metastases, as has already been reported. However, this study demonstrated that surgical treatment and appropriate follow-up therapy might result in better prognoses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of pleomorphic carcinoma of the lung

Ito¹,

Oizumi²,

Fukumoto³

et al. 2010

Lung Cancer

104

View full text Add to dashboard Cite

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“…During the clinical period, pathological diagnosis was routinely determined according to the 2004 WHO lung cancer classification, using hematoxylin and eosin‐stained formalin‐fixed paraffin‐embedded 4 μm sections 5. IHC was then performed using the universal immune‐peroxidase polymer method to detect chromogranin A (IR502, Agilent, Santa Clara, USA), synaptophysin (PA0299, Leica Biosystems, Wetzlar, Germany), and CD56 (MRQ‐42, Nichirei Biosciences, Tokyo, Japan).…”

Section: Endobronchial Ultrasound‐guided Transbronchial Needle Aspiramentioning

confidence: 99%

“…The sections were reevaluated according to 2015 WHO criteria by independent board‐certified pathologists (Fig 1). 5 …”

Section: Endobronchial Ultrasound‐guided Transbronchial Needle Aspiramentioning

confidence: 99%

Pathological diagnosis of pulmonary large cell neuroendocrine carcinoma by endobronchial ultrasound‐guided transbronchial needle aspiration

et al. 2017

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BackgroundPulmonary large cell neuroendocrine carcinoma (LCNEC) is a relatively rare subtype of lung malignancy. According to revised 2015 World Health Organization (WHO) criteria for the pathological diagnosis of LCNEC, neuroendocrine markers must be examined by immunohistochemistry. In this study, we reevaluated endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) samples of patients previously diagnosed with LCNEC using the revised WHO criteria.MethodsClinical tissue samples that had been obtained by EBUS‐TBNA between January 2004 and December 2011, and that had been pathologically diagnosed as LCNEC according to the previous criteria, were reevaluated according to the revised WHO criteria.ResultsThe records of 471 lung cancer patients with mediastinal or hilar lymph node metastasis diagnosed by EBUS‐TBNA were analyzed. Thirteen patients were diagnosed with LCNEC; one of which was diagnosed based on cytology alone because the histological material was insufficient for a histological examination. Among the 12 cases in which a histological examination was performed, nine were diagnosed with possible LCNEC based on neuroendocrine marker positivity, while three were diagnosed with suspected LCNEC because they did not meet the immunostaining criteria. The patient who was cytologically diagnosed was found to have non‐small cell carcinoma with neuroendocrine morphology.ConclusionLCNEC could be pathologically diagnosed based on 2015 WHO criteria using EBUS‐TBNA samples.

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“…1 Large cell and adenocarcinomas are more frequently found on the periphery of the lungs, in contrast to squamous cell carcinomas that tend to be more centrally located. Squamous cell carcinomas frequently are slower growing and metastasize late.…”

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confidence: 99%

A novel five-antibody immunohistochemical test for subclassification of lung carcinoma

Ring¹,

Seitz

Beck

et al. 2009

Modern Pathology

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Malignant epithelial lung carcinoma can be subclassified by histology into several tumor types, including adenocarcinoma and squamous cell carcinoma. The need for a uniform method of classifying lung carcinomas is growing as clinical trials reveal treatment and side effect differences associated with histological subtypes. Diagnosis is primarily performed by morphological assessment. However, the increased use of needle biopsy has diminished the amount of tissue available for interpretation. These changes in how lung carcinomas are diagnosed and treated suggest that the development of improved molecular-based classification tools could improve patient management. We used a 551-patient surgical specimen lung carcinoma retrospective cohort from a regional hospital to assess the association of a large number of proteins with histological type by immunohistochemistry. Five of these antibodies, targeting the proteins TRIM29, CEACAM5, SLC7A5, MUC1, and CK5/6, were combined into one test using a weighted algorithm trained to discriminate adenocarcinoma from squamous cell carcinoma. Antibody-based classification on 600 lM tissue array cores with the fiveantibody test was compared to standard histological evaluation on surgical specimens in three independent lung carcinoma cohorts (combined population of 1111 patients). In addition, the five-antibody test was tested against the two-marker panel thyroid transcription factor-1 (TTF-1) and TP63. Both the five-antibody test and TTF-1/TP63 panel had similarly low misclassification rates on the validation cohorts compared to morphological-based diagnosis (4.1 vs 3.5%). However the percentage of patients remaining unclassifiable by TTF-1/TP63 (22%, 95% CI: 20-25%) was twice that of the five-antibody test (11%, 95% CI: 8-13%). The results of this study suggest the five-antibody test may have an immediate function in the clinic for helping pathologists distinguish lung carcinoma histological types. The results also suggest that if validated in prospectively defined clinical trials this classifier might identify candidates for targeted therapy that are overlooked with current diagnostic approaches.

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The 2004 World Health Organization classification of lung tumors

Cited by 502 publications

References 86 publications

Clinical characteristics of pleomorphic carcinoma of the lung

Clinical characteristics of pleomorphic carcinoma of the lung

Pathological diagnosis of pulmonary large cell neuroendocrine carcinoma by endobronchial ultrasound‐guided transbronchial needle aspiration

A novel five-antibody immunohistochemical test for subclassification of lung carcinoma

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