Morphological Features of the Most Advanced Intra-Tumor Component in Multistep Progression

Yasushi Yatabe

doi:10.6058/jlc.2010.9.2.53

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Yatabe: Morphological Features of the Most Advanced Intra-Tumor Component in Multistep Progression

Original Article

J Lung Cancer 2010;9(2):53-56.

Published online: 10 January 2010

DOI: https://doi.org/10.6058/jlc.2010.9.2.53

Morphological Features of the Most Advanced Intra-Tumor Component in Multistep Progression

Yasushi Yatabe, M.D.

Department of Pathology and Molecular Diagnosis, Aichi Cancer Center, Nagoya, Japan

Address for correspondence Yasushi Yatabe, M.D. Department of Pathology and Molecular Diagnosis, Aichi Cancer Center, Nagoya 464-8681, Japan Tel: 81-52-762-6111 Fax: 81-52-757-4810 E-mail: yyatabe@aichi-cc.jp

Received 15 November 2010 Accepted 20 November 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Advances in basic life science during the past decade have exponentially increased our understanding of the molecular bases of lung cancers and this improved insight has had great effects on diagnosis, prognosis, classification, and treatment of cancer. Similar to colorectal carcinoma, stepwise development of lung cancer has been proposed. For squamous neoplasm, dysplasia is considered to progress to invasive cancer through carcinoma in-situ in association with accumulations of genetic and epigenetic alterations. In lung adenocarcinoma, a preinvasive lesion, termed atypical adenomatous hyperplasia, progresses to an adenocarcinoma in situ, namely a bronchioloalveolar carcinoma, followed by an invasive adenocarcinoma. Currently, molecular alterations, which are involved in each transition, have been also revealed. In this review, I would like to discuss correlation of morphological features with the progression of lung adenocarcinoma with special reference to the most advanced component within the tumor.

Keywords: Lung neoplasms, Disease progression, Cell morphology, Epidermal growth factor receptor

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Figures

Fig. 1.

Four tissue samples from a single tumor. Morphologically, the four components were different with respect to the growth pattern and cellular atypia. All of the four components (A to D) harbored an epidermal growth factor receptor (EGFR) mutation, but EGFR amplification was detected only in components (B) and (D).

Fig. 2.

The primary tumor (A) and the metastasis in the lymph node (B) in a patient treated with gefitinib. A secondary mutation, T790M, was superimposed only in the regrown primary tumor (A); the L858R point mutation was detected in both tumors.

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