07/28/2010
Lung mass
40-year-old male with a solid 10 cm. mass in left lung. History of a long-term heavy smoker for 13 years.
Procedure: CT-guided fine needle biopsy.
Micro: Numerous tumor cells are noted. Pap stain
Correlation: Related biopsy slide is available (see Images 11 to 16)
IHC stains:
Pankeratin Positive
CK7 Positive
CK20 Negative
CK5/6 Negative
TTF-1 Negative
- Case Overview
- Diagnosis
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Comments
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I agree to Dr. Qiao's observation of mixed cells. Sir, I feel it is an adenosquamous ca lung.
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i have same idea with Doctor Mahmoud Farouk. There is a typical smear of Adenocarcinoma of lung.
I see this is a good example of adenocarcinoma featuring loose groups of markedly atypica cells with many separate cells on the background. Features of glandular differentiation in this case include (1) Delicate cytoplasm- image 1, image 10,image 9, image 8. (2) Intracytoplasmic channels image 4, image 9 (seen also in the biopsy specimen). The presence of CK7 positivity favouring lung origin of this neoplasm.
It shows a poorly differentiated squamous cell carcinoma composed of tumor cells arranged as squamous or solid fashion with moderate to high N/C ratio. A few adenocarcinomatous tumor cells can be discernible also.
This is a good example that most of lung cancers show mixed cell types, and in this case you can definitely see the adenocarcinoma component!
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