1. Distal-type bronchiolar adenoma of the lung expressing p16 INK4a - morphologic, immunohistochemical, ultrastructural and genomic analysis - report of a case and review of the literature.
- Author
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Tachibana M, Saito M, Kobayashi J, Isono T, Yatabe Y, and Tsutsumi Y
- Subjects
- Adenocarcinoma of Lung metabolism, Adenocarcinoma of Lung pathology, Adenocarcinoma of Lung surgery, Adenoma metabolism, Adenoma pathology, Adenoma surgery, Aged, Bronchioles metabolism, Bronchioles pathology, Bronchioles surgery, Cyclin-Dependent Kinase Inhibitor p16 genetics, Female, Goblet Cells metabolism, Goblet Cells pathology, Humans, Immunohistochemistry, Lung Neoplasms metabolism, Lung Neoplasms pathology, Lung Neoplasms surgery, Microscopy, Electron, Tomography, X-Ray Computed, Adenocarcinoma of Lung diagnostic imaging, Adenoma diagnostic imaging, Cyclin-Dependent Kinase Inhibitor p16 metabolism, Lung Neoplasms diagnostic imaging, Mucins metabolism
- Abstract
Bronchiolar adenoma (BA) of the lung is a rare benign neoplasm. Because of a chest abnormal shadow indicated by health checkup, a 77-year-old female nonsmoker underwent computed tomography, revealing an 8 mm ground glass nodule in the peripheral field of the right lower lobe. Wedge resection of the nodule was performed, with a frozen diagnosis of primary lung adenocarcinoma. The localized, 8 × 4 × 3 mm-sized, jelly-like mass microscopically revealed a lepidic-growing lesion composed of ciliated columnar cells, mucous cells and basal cells surrounded by mucin pool. Neither nuclear atypia nor mitotic activity was noted. Immunohistochemically, the ciliated, mucous and basal cells were positive for TTF-1 and p16
INK4a . Mucous cells were positive for napsin A and focally expressed MUC5AC. MUC6 was negative. Basal cells were positive for CK5/6, p40, p63 and podoplanin. Human papillomavirus genome was undetectable by in situ hybridization. Ultrastructurally, the bronchiolar epithelial tubules consisted of two layers, the inner nonciliated microvillous cells and the outer basal-like cells, and some of the inner cells were filled with mucin granules in cytoplasm. Molecular analysis of the tumor failed to show driver mutations. The final diagnosis was distal-type BA. The postoperative course was uneventful for 6 months., (© 2020 The Authors. Pathology International published by Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.)- Published
- 2020
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