Pulmonary Pathology Online
Pathology of Mucinous (colloid) Adenocarcinoma of the Lung
(colloid) adenocarcinoma of the lung is an unusual variant of
Discrimination between these tumours, mucinous cystadenomas, and metastatic lesions with mucinous features may prove challenging, especially on small biopsy specimens.
Mucinous (colloid) adenocarcinoma is suspected when a gelatinous substance like strawberry jelly is observed intraoperatively in the lung.
Grossly, the tumours are usually poorly circumscribed, soft, tan-to-gray mucoid lesions.
Mucinous (colloid) adenocarcinoma of the lung represents an entity with two distinct clinicopathologic and immunophenotypic variants:
(1) the goblet cell-type, presenting a more indolent clinical behavior and frequently co-expressing markers of intestinal and pulmonary differentiation; and
(2) the more aggressive signet-ring cell-type, which retains only markers of pulmonary origin.
Because it shares similar histologic features with mucinous adenocarcinomas of the gastrointestinal tract, ovary, and breast.
Pulmonary Mucinous (colloid) adenocarcinoma may require immunohistochemical analysis to confirm the primary site of the tumour.
- Patients with goblet cell - type MCC are more common and are frequently immunoreactive for intestinal-type markers such as CDX2, cytokeratin 20 (CK20), and MUC-2.
Additionally, the latter tumours appear to have a better prognosis.
- The less frequent signet ring cell - type MCC is immunoreactive for markers of pulmonary origin, such as TTF-1 and CK7, and nonreactive for intestinal-type markers such as CDX2, MUC2, and CK20.
In contrast to the goblet cell - type Mucinous (colloid) adenocarcinoma , signet ring - type tumours are associated with a poorer prognosis.
Mucinous cystadenoma is a benign neoplasm that is generally much smaller, has a fibrous capsule, and lacks the cytologic atypia seen in carcinomas.
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Mucinous (so-called colloid) carcinoma of the lung.Am J Surg Pathol. 2004 Oct;28(10):1397; author reply 1397.
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