Journal List > Korean J Cytopathol > v.19(2) > 1006530

Korean J Cytopathol. 2008 Sep;19(2):206-208. English.
Published online September 30, 2008.  https://doi.org/10.3338/kjc.2008.19.2.206
Copyright © 2008 The Korean Society for Cytopathology
Pulmonary Adenocarcinoma with a Micropapillary Pattern Detected by Bronchial Washing - A Brief Case Report -
Jae Hong Park, M.D., Seung Yeon Ha, M.D., Hyun Yee Cho, M.D., Dong Hae Chung, M.D., Na Rae Kim, M.D. and Sanghui Park, M.D.
Department of Pathology, Gachon University, Gil Hospital, Incheon, Korea.
Received July 16, 2008; Accepted September 04, 2008.

Abstract

Adenocarcinomas with micropapillary patterns are generally aggressive and show lymphotropism. Only a few reports on pulmonary adenocarcinoma with micropapillary patterns have described cytologic findings. A 70-year-old Korean woman was admitted to the hospital because of intermittent dry cough and chest pain. Cytology after bronchial washing showed neoplastic cells in small, angulated, cohesive clusters consisting of 3-20 cells without a fibrovascular core. The resected right middle lobe showed a tumor occupying almost the entire lobe. Histologically, about 90% of neoplastic cells proliferated with micropapillary morphology in the background of bronchioloalveolar carcinoma. Cytologic smears of a bronchial washing showing tumor cells in small, cohesive clusters without a fibrovascular core may indicate an adenocarcinoma with micropapillary pattern.

Keywords: Lung; Micropapillary; Cytology

Figures


Fig. 1
Cytologic findings of bronchial washing. A cohesive cluster of neoplastic cells, consisting of less than 20 cells without fibrovascular core and resulting in micropapillary configuration, is observed (Papanicolaou stain).
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Fig. 2
Gross findings. Almost entire lobe was occupied by a tumor. There is partially torn visceral pleura in the right lower portion.
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Fig. 3
Histologic findings. Most neoplastic cells proliferate and form small nests without a fibrovascular core in the background of bronchioloalveolar carcinoma (H&E).
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References
1. Amin MB, Tamboli P, Merchant SH, et al. Micropapillary component in lung adenocarcinoma. A distinctive histologic feature with possible prognostic significance. Am J Surg Pathol 2002;26:358–364.
2. Hoshi R, Tsuzuku M, Horai T, Ishikawa Y, Satoh Y. Micropapillary clusters in early-stage lung adenocarcinomas. A distinct cytologic sign of significantly poor prognosis. Cancer Cytopathol 2004;102:81–86.
3. Kuroda N, Hamaguchi N, Ohara M. Intracytoplasmic lumina in invasive micropapillary carcinoma of the lung. Diagn Cytopathol 2006;34:224–226.
4. Duncan LD, Jacob S, Atkinson S. Fine needle aspiration cytologic findings of micropapillary carcinoma in the lung: a case report. Acta Cytol 2007;51:605–609.
5. Miyoshi T, Satoh Y, Okumura S, et al. Early-stage lung adenocarcinomas with a micropapillary pattern, a distinct pathologic marker for a significantly poor prognosis. Am J Surg Pathol 2003;27:101–109.