Pulmonary adenocarcinomas of the fetal lung type - A clinicopathologic study indicating differences in histology, epidemiology, and natural history of low-grade and high-grade forms

被引:90
作者
Nakatani, Y
Kitamura, H
Inayama, Y
Kamijo, S
Nagashima, Y
Shimoyama, K
Nakamura, N
Sano, J
Ogawa, N
Shibagaki, T
Resl, M
Mark, EJ
机构
[1] Hosp Yokohama City Univ, Sch Med, Div Anat & Surg Pathol, Kanazawa Ku, Yokohama, Kanagawa 2360004, Japan
[2] Yokohama City Univ, Urafune Hosp, Dept Pathol & Lab Med, Yokohama, Kanagawa 232, Japan
[3] Yokohama City Univ, Sch Med, Dept Pathol, Yokohama, Kanagawa 232, Japan
[4] Yokohama Citizens Hosp, Dept Pathol, Yokohama, Kanagawa, Japan
[5] Kanagawa Prefectural Cardiovasc & Resp Ctr, Dept Pathol, Yokohama, Kanagawa, Japan
[6] Kanagawa Prefectural Cardiovasc & Resp Ctr, Dept Surg, Yokohama, Kanagawa, Japan
[7] Charles Univ, Sch Med, Dept Pathol, CS-50165 Hradec Kralove, Czech Republic
[8] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Pathol, Boston, MA USA
关键词
adenocarcinoma of fetal lung type; pulmonary blastoma; pulmonary endodermal tumor resembling fetal lung; pleuropulmonary blastoma; alpha-fetoprotein;
D O I
10.1097/00000478-199804000-00003
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Seven cases of high-grade adenocarcinoma of fetal lung type (H-FLAC) are compared with nine cases of pulmonary endodermal tumor resembling fetal lung or low-grade adenocarcinoma of fetal lung type (L-FLAC). Of the seven patients with of H-FLAC, four were men and three were women. All of the patients but one were in their 60s or 70s. Five patients were smokers. After resection of the tumor, three patients died of metastases, two patients are alive with no evidence of disease, and two patients died of a postoperative complication. Histologically, H-FLAC and L-FLAC have both complex glandular structures resembling fetal lung and neuroendocrine differentiation. Two cases of H-FLAC had stromal proliferation typical of biphasic pulmonary blastoma. The H-FLAC was distinguished from L-FLAC by the presence of disorganized glands, large vesicular nuclei, prominent nucleoli, pronounced aniso-nucleosis, absence of morules, transition to conventional adenocarcinoma, broad areas of necrosis, desmoplastic stroma, overexpression of p53 protein, and production of alpha-fetoprotein. High and low grades of FLAG explain discrepancies in previously reported clinicopathologic features of FLAG. The H-FLAC needs to be distinguished from L-FLAC. Both forms may have stromal components, so both have been referred to as blastomas. The H-FLAC represents the prototype of so-called pulmonary blastoma predominantly seen in the elderly, whereas L-FLAC and its biphasic form predominate in the middle-aged population.
引用
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页码:399 / 411
页数:13
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