LUNG CANCER

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Interpretation & Reporting

IHC and special stains

+The Lung-Restricted Marker Napsin A Is Highly Expressed in Clear Cell Carcinomas of the Ovary
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A study highlighting an important pitfall with napsin A immunohistochemistry, which is expressed not only by lung adenocarcinoma but also by clear cell carcinoma of the ovary


The Lung-Restricted Marker Napsin A Is Highly Expressed in Clear Cell Carcinomas of the Ovary

Patricia L. Kandalaft, MD; Allen M. Gown, MD; Christina Isacson, MD

A study highlighting an important pitfall with napsin A immunohistochemistry, which is expressed not only by lung adenocarcinoma but also by clear cell carcinoma of the ovary
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+Pulmonary Large Cell Neuroendocrine Carcinoma with Adenocarcinoma-like Features: Napsin A Expression and Genomic Alterations
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This study examines the pathologic/genetic features and clinical behavior of LCNEC with adenocarcioma-like features.


Pulmonary Large Cell Neuroendocrine Carcinoma with Adenocarcinoma-like Features: Napsin A Expression and Genomic Alterations

Rekhtman N, Pietanza CM, Sabari J, et al.

This study examines the pathologic/genetic features and clinical behavior of LCNEC with adenocarcioma-like features.
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+Lymphohistiocytoid Mesothelioma of the Pleura
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This article reviews the pathologic, immunophenoptypic and cytogenetic features of 4 cases of lymphohistiocytoid mesothelioma.


Lymphohistiocytoid Mesothelioma of the Pleura

Kawai T, Hiroi S, Nakanishi K, et al.

This article reviews the pathologic, immunophenoptypic and cytogenetic features of 4 cases of lymphohistiocytoid mesothelioma. This is a useful review of a rare but important entity.
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+PD-L1 Immunohistochemistry in Clinical Diagnostics of Lung Cancer: Inter-pathologist Variability is Higher than Assay Variability 
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This study looked at concordance between different PD-L1 IHC antibody clones. Found good concordance between 22C3, 28-8 and SP263 and suggests the antibodies can be used interchangably for various targeted therapies.


PD-L1 Immunohistochemistry in Clinical Diagnostics of Lung Cancer: Inter-pathologist Variability is Higher than Assay Variability

Brunnstrom H, Johansson A, Westbom-Fremer S, et al.

This study looked at concordance between different PD-L1 IHC antibody clones. Found good concordance between 22C3, 28-8 and SP263 and suggests the antibodies can be used interchangably for various targeted therapies.
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+ Programmed Death Ligand-1 (PD-L1) Expression in the Programmed Death Receptor-1 (PD-1)/PD-L1 Blockade 
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A nice review for pathologists of the current understanding regarding PD-1 and PD-L1. Includes a nice review of all available PD-L1 antibodies, platforms, and scoring differences.


NEW: Programmed Death Ligand-1 (PD-L1) Expression in the Programmed Death Receptor-1 (PD-1)/PD-L1 Blockade

Guan J, Kim K, Mekhail T, et al.

A nice review for pathologists of the current understanding regarding PD-1 and PD-L1. Includes a nice review of all available PD-L1 antibodies, platforms, and scoring differences.
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+Primary Oncocytic Adenocarcinomas of the Lung: A Clinicopathologic, Immunohistochemical, and Molecular Biologic Analysis of 16 Cases
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Paper describes interetsting and rare variant of oncocytic lung adenocarcinoma. Useful paper with strong scientific merit.


Primary Oncocytic Adenocarcinomas of the Lung: A Clinicopathologic, Immunohistochemical, and Molecular Biologic Analysis of 16 Cases

Luisa M. Solis, MD; M. Gabriela Raso, MD; Neda Kalhor, MD; et al.

Paper describes interetsting and rare variant of oncocytic lung adenocarcinoma. Useful paper with strong scientific merit.
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+Usefulness of Cdx2 in Separating Mucinous Bronchioloalveolar Adenocarcinoma of the Lung From Metastatic Mucinous Colorectal Adenocarcinoma
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Study found CDX2 is a specific and sensitive marker for distinguishing metastatic colorectal carcinoma from primary mucinous lung adenocarcinoma.


Usefulness of Cdx2 in Separating Mucinous Bronchioloalveolar Adenocarcinoma of the Lung From Metastatic Mucinous Colorectal Adenocarcinoma

Reda S. Saad, MD, PhD; Patrick Cho, MD; Jan F. Silverman, MD; Yulin Liu, MD, PhD

Study found CDX2 is a specific and sensitive marker for distinguishing metastatic colorectal carcinoma from primary mucinous lung adenocarcinoma.
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+Improving Selection Criteria for ALK Inhibitor Therapy in Non–Small Cell Lung Cancer: A Pooled-Data Analysis on Diagnostic Operating Characteristics of Immunohistochemistry
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This study evaluates the diagnostic role of ALK immunohistochemistry (IHC) in identification of ALK rearrangement compared to FISH.


Improving Selection Criteria for ALK Inhibitor Therapy in Non–Small Cell Lung Cancer: A Pooled-Data Analysis on Diagnostic Operating Characteristics of Immunohistochemistry

Jiang, Long MD, PhD; Yang, Haihong MD, PhD; He, Ping MD, PhD, et al.

This study evaluates the diagnostic role of ALK immunohistochemistry (IHC) in identification of ALK rearrangement compared to FISH. Authors conclude that IHC scores of 0 and 3+ were nearly 100% concordant with FISH-negative and FISH-positive status, respectively. However, IHC scores 1+ and 2+ might require further confirmatory testing by FISH assay. IHC assay using D5F3 and 5A4 antibodies reliably detected NSCLC with ALK rearrangement and may be useful as a screening method to identify these tumors.
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+EBUS-TBNA as a Promising Method for the Evaluation of Tumor PD-L1 Expression in Lung Cancer
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This article reviews the validity of PD-L1 expression testing in EBUS obtained cytology samples using the EPR116 Abcam antibody.


EBUS-TBNA as a Promising Method for the Evaluation of Tumor PD-L1 Expression in Lung Cancer

Sakakibara R, Inamura K, Tambo Y, et al.

This article reviews the validity of PD-L1 expression testing in EBUS obtained cytology samples using the EPR116 Abcam antibody. The authors found superior yields with EBUS vs transbronchial biopsies and good concordnace between EBUS specimen and primary tumor for PD-L1 expression.
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+GATA3 Immunohistochemistry for Distinguishing Sarcomatoid and Desmoplastic Mesothelioma From Sarcomatoid Carcinoma of the Lung.
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The authors suggest using GATA3 immunostain as a marker to distinguish between sarcomatoid lung carcinomas and sarcomatoid mesotheliomas.


GATA3 Immunohistochemistry for Distinguishing Sarcomatoid and Desmoplastic Mesothelioma From Sarcomatoid Carcinoma of the Lung.

Berg, Kyra B. MD; Churg, Andrew MD

The authors suggest using GATA3 immunostain as a marker to distinguish between sarcomatoid lung carcinomas and sarcomatoid mesotheliomas. This stain shows a diffuse positivity with the latter but is mostly negative in sarcomatoid lung carcinomas.
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+A Sensitive ALK Immunohistochemistry Companion Diagnostic Test Identifies Patients Eligible for Treatment with Crizotinib
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A study on the automated ALK (D5F3) companion diagnostic IHC assay available from Ventana and its correlation with outcomes for patients with ALK-rearranged lung cancers


A Sensitive ALK Immunohistochemistry Companion Diagnostic Test Identifies Patients Eligible for Treatment with Crizotinib

Thorne-Nuzzo T, et al.

A study on the automated ALK (D5F3) companion diagnostic IHC assay available from Ventana and its correlation with outcomes for patients with ALK-rearranged lung cancers
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FISH and molecular testing

NEW+Prevalence of Delta-like Protein 3 Expression in Patients with Small Cell Lung Cancer
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Delta-like protein 3 was found by immunohistochemistry to be expressed in 83% of small cell carcinomas, of which 32% were high expressors (at least half of tumor cells positive).


Prevalence of Delta-like Protein 3 Expression in Patients with Small Cell Lung Cancer

Tanaka K, Isse K, Fujihira T, et al.

Delta-like protein 3 was found by immunohistochemistry to be expressed in 83% of small cell carcinomas, of which 32% were high expressors (at least half of tumor cells positive). No patient feature, including expression level, affected survival.
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+Characterization of 298 Patients with Lung Cancer Harboring MET Exon 14 Skipping Alterations
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The clinicopathologic characterstics of a large cohort of Lung Cancer cases Harboring MET Exon 14 Skipping Alterations is discussed.


Characterization of 298 Patients with Lung Cancer Harboring MET Exon 14 Skipping Alterations

Schrock A, Frampton G, Suh J, et al.

The clinicopathologic characterstics of a large cohort of Lung Cancer cases Harboring MET Exon 14 Skipping Alterations is discussed.
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+Mucinous Micropapillary Pattern in Lung Adenocarcinomas: A Unique Histology with Genetic Correlates
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Mucinous and non-mucinous micropapillary adenocarcinomas of the lung are explored clinically and genetically. Authors found that tumours with mucinous micropapillary component exhibited significantly more aggressive pathological features, a higher proportion of HER2 mutations and ALK rearrangements, and a lower proportion of EGFR mutations compared to those with a non-mucinous micropapillary component.


Mucinous Micropapillary Pattern in Lung Adenocarcinomas: A Unique Histology with Genetic Correlates

Kamata T, Yoshida A, Shiraishi K, et al.

Mucinous and non-mucinous micropapillary adenocarcinomas of the lung are explored clinically and genetically. Authors found that tumours with mucinous micropapillary component exhibited significantly more aggressive pathological features, a higher proportion of HER2 mutations and ALK rearrangements, and a lower proportion of EGFR mutations compared to those with a non-mucinous micropapillary component.
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+Template for Reporting Results of Biomarker Testing of Specimens From Patients With Non–Small Cell Carcinoma of the Lung
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The College of American Pathologists suggested templates when reporting results of biomarker testing to assist pathologists in providing clinically useful and relevant information


Template for Reporting Results of Biomarker Testing of Specimens From Patients With Non–Small Cell Carcinoma of the Lung

Philip T. Cagle, MD; Lynette M. Sholl, MD; Neal I. Lindeman, MD, et al.

The College of American Pathologists suggested templates when reporting results of biomarker testing to assist pathologists in providing clinically useful and relevant information
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Other considerations

NEW+Distinct Clinicopathologic Features, Genomic Characteristics and Survival of Central and Peripheral Pulmonary Large Cell Neuroendocrine Carcinoma: From Different Origin Cells?
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126 large cell neuroendocrine carcinomas were divided into peripheral (64%) and central (invasion of lobar or segmental bronchi), revealing several distinct differences including better survival, smaller size, lower stage, and higher levels of EGFR and retinoblastoma-1 mutations in the peripheral category.


Distinct Clinicopathologic Features, Genomic Characteristics and Survival of Central and Peripheral Pulmonary Large Cell Neuroendocrine Carcinoma: From Different Origin Cells?

Zhou F, Hou L, Ding T, et al.

126 large cell neuroendocrine carcinomas were divided into peripheral (64%) and central (invasion of lobar or segmental bronchi), revealing several distinct differences including better survival, smaller size, lower stage, and higher levels of EGFR and retinoblastoma-1 mutations in the peripheral category.
https://www.ncbi.nlm.nih.gov/pubmed/20618734

+A Grading System Combining Tumor Budding and Nuclear Diameter Predicts Prognosis in Resected Lung Squamous Cell Carcinoma
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This study proposes a grading system for squamous cell carcinoma based on nuclear size and budding growh pattern, both fond to be independent prognostc factors for worse overall survival


A Grading System Combining Tumor Budding and Nuclear Diameter Predicts Prognosis in Resected Lung Squamous Cell Carcinoma

Kadota K, Miyai Y, Katsuki N, et al.

This study proposes a grading system for squamous cell carcinoma based on nuclear size and budding growh pattern, both fond to be independent prognostc factors for worse overall survival
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+Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group
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These guidelines are produced by experts in the field and are intended to provide practical directions on the pathologic diagnosis of mesothelioma.


Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group

Husain AN, Colby TV, Ordóñez NG, et al.

These guidelines are produced by experts in the field and are intended to provide practical directions on the pathologic diagnosis of mesothelioma.
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NEW+Cribriform and Fused Glands are Patterns of High-Grade Pulmonary Adenocarcinoma
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This study looked at the clinical significance of cribriform and fused glandular adenocarcinoma.


Cribriform and Fused Glands are Patterns of High-Grade Pulmonary Adenocarcinoma

Moreira AL, Joubert P, Downey RJ, and Rekhtman N.

This study looked at the clinical significance of cribriform and fused glandular adenocarcinoma. The findings indicate cribriform and fused patterns are seen in 15% and 29% of tumors, respectively, and are associated with worse behavior.
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+Tumor Spread through Air Spaces Affects the Recurrence and Overall Survival in Patients with Lung Adenocarcinoma >2 to 3 cm 
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In this study the effects of the combination of Tumor spread through air spaces (STAS) and tumor size on survival have been studied. The authors suggest considering STAS in the staging system.


Tumor Spread through Air Spaces Affects the Recurrence and Overall Survival in Patients with Lung Adenocarcinoma >2 to 3 cm

Dai, Xie, Su, et al.

In this study the effects of the combination of Tumor spread through air spaces (STAS) and tumor size on survival have been studied. The authors suggest considering STAS in the staging system.
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+Dataset for Reporting of Malignant Mesothelioma of the Pleura or Peritoneum: Recommendations from the International Collaboration on Cancer Reporting (ICCR) 
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The authors describe a dataset developed by an expert panel for reporting pathologic elements of mesothelioma. The dataset has 8 required and 7 recommended elements that should be included in the pathology report.


Dataset for Reporting of Malignant Mesothelioma of the Pleura or Peritoneum: Recommendations from the International Collaboration on Cancer Reporting (ICCR)

Churg A, Attanoos R, Borczuk AC, et al.

The authors describe a dataset developed by an expert panel for reporting pathologic elements of mesothelioma. The dataset has 8 required and 7 recommended elements that should be included in the pathology report.
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+Risk Assessment in Solitary Fibrous Tumors: Validation and Refinement of a Risk Stratification Model 
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This study evaluates the previous risk stratification model of solitary fibrous tumor and reviews the importance of necrosis.


Risk Assessment in Solitary Fibrous Tumors: Validation and Refinement of a Risk Stratification Model

Demicco EG, Wagner MJ, Maki RG, et al.

This study evaluates the previous risk stratification model of solitary fibrous tumor and reviews the importance of necrosis.
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+Neuroendocrine Carcinomas of the Lung
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Good review of neuroendocrine tumors from 2009.


Neuroendocrine Carcinomas of the Lung

Cesar A. Moran, MD; Saul Suster, MD; Domenico Coppola, MD; Mark R. Wick, MD

Good review of neuroendocrine tumors from 2010. 
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+Primary Sclerosing Neuroendocrine Carcinomas of the Lung: A Clinicopathologic and Immunohistochemical Study of 10 Cases
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This study looks at sclerotic variant carcioind tumor. Useful review of unusual variant of common tumor.


Primary Sclerosing Neuroendocrine Carcinomas of the Lung: A Clinicopathologic and Immunohistochemical Study of 10 Cases

Neda Kalhor, MD; Saul Suster, MD; Cesar A. Moran, MD

This study looks at sclerotic variant carcioind tumor. Useful review of unusual variant of common tumor.
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+Papillary Lung Carcinoma with Prominent "Morular" Component
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Older study that reports the unusual finding of spindle cell morules in cases of papillary adenocarcinoma.


Papillary Lung Carcinoma with Prominent "Morular" Component

Cesar A. Moran, MD; Jaishree Jagirdar, MD, and Saul Suster, MD

Older study that reports the unusual finding of spindle cell morules in cases of papillary adenocarcinoma.
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+Semiquantitative Assessment of Tumor Spread through Air Spaces (STAS) in Early-Stage Lung Adenocarcinomas
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Authors performed a semiquantitative assessmentof STAS in surgically removed small (≤2 cm) stage I lung adenocarcinomas.


Semiquantitative Assessment of Tumor Spread through Air Spaces (STAS) in Early-Stage Lung Adenocarcinomas

Hironori U., Takeshi F., Sakashi F., et al.

Authors performed a semiquantitative assessmentof STAS in surgically removed small (≤2 cm) stage I lung adenocarcinomas. STAS was associated with aggressive behavior.
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+Evaluation of the 7th and 8th editions of the AJCC/UICC TNM staging systems for lung cancer in a large North American cohort. Oncotarget. 2017 May 24.
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The authors discuss modifications to the most recent staging system for lung cancer, highlighting improvements and contrasting with the prior staging system.


Evaluation of the 7th and 8th editions of the AJCC/UICC TNM staging systems for lung cancer in a large North American cohort. Oncotarget. 2017 May 24.

Yang L, Wang S, Zhou Y, et al.

The authors discuss modifications to the most recent staging system for lung cancer, highlighting improvements and contrasting with the prior staging system.
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+Challenges of Frozen Section in Thoracic Pathology: Lepidic Lesions, Limited Resections, and Margins
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This article discusses the pitfalls and challenges in frozen section evaluation. Common and rare scenarios are reviewed.


Challenges of Frozen Section in Thoracic Pathology: Lepidic Lesions, Limited Resections, and Margins

Borczuk AC.

This article discusses the pitfalls and challenges in frozen section evaluation. Common and rare scenarios are reviewed.
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+Lung Carcinoma Staging Update
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This short article is a brief review of the 8th edition staging system for lung cancer. The article primarily discusses the main changes to the T, N and M categories


Lung Carcinoma Staging Update

Dacic, S

This short article is a brief review of the 8th edition staging system for lung cancer. The article primarily discusses the main changes to the T, N and M categories
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+The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification
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A nice and concise summary of the changes and additions made in the new 2015 WHO Classification of Lung Tumors


The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification

Travis WD, et al.

A nice and concise summary of the changes and additions made in the new 2015 WHO Classification of Lung Tumors
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+Solitary fibrous tumor: a clinicopathological study of 110 cases and proposed risk assessment model
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A risk assessment model for determining the likelihood for malignant behavior in solitary fibrous tumors, including those arising in the lung


Solitary fibrous tumor: a clinicopathological study of 110 cases and proposed risk assessment model

Demicco EG, et al.

A risk assessment model for determining the likelihood for malignant behavior in solitary fibrous tumors, including those arising in the lung
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