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Desai N, D'Ambrosio D, Dombrowski KS, Illei PB, Heymann JJ. Pulmonary Cytopathology: Current and Future Impact of Microscopy and Immunohistochemistry. Surg Pathol Clin 2024; 17:411-429. [PMID: 39129140 DOI: 10.1016/j.path.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
With the advancement of tissue procurement techniques, in-depth knowledge of morphology is crucial for cytopathologists to diagnose neoplastic and nonneoplastic lung diseases optimally. Cytopathologists must also be well versed in immunohistochemistry/immunocytochemistry markers and their interpretation for an accurate diagnosis.
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Affiliation(s)
- Niyati Desai
- Department of Pathology and Cell Biology, New York-Presbyterian Hospital-Columbia University Irving Medical Center, 630 West 168th Street, New York, NY 10032, USA
| | - Danielle D'Ambrosio
- Department of Pathology, New York University Grossman School of Medicine, 560 First Avenue, New York, NY 10016, USA
| | - Katya S Dombrowski
- Department of Pathology, The Johns Hopkins University School of Medicine, 600 North Wolfe St., Baltimore, MD 21287, USA
| | - Peter B Illei
- Department of Pathology, The Johns Hopkins University School of Medicine, 600 North Wolfe St., Baltimore, MD 21287, USA
| | - Jonas J Heymann
- Department of Pathology and Laboratory Medicine, New York-Presbyterian Hospital-Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA.
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Canberk S, Field A, Bubendorf L, Chandra A, Cree IA, Engels M, Hiroshima K, Jain D, Kholová I, Layfield L, Mehrotra R, Michael C, Osamura R, Pitman MB, Roy-Chowdhuri S, Satoh Y, VanderLaan P, Zakowski M, Schmitt FC. A brief review of the WHO reporting system for lung cytopathology. J Am Soc Cytopathol 2023; 12:251-257. [PMID: 37156705 DOI: 10.1016/j.jasc.2023.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 05/10/2023]
Abstract
The International Academy of Cytology has joined with the International Agency for Research on Cancer to bring together a group of experts in lung cytopathology to develop a WHO Reporting System for Lung Cytopathology (WHO System). This System aims to improve and standardize the reporting of cytopathology, facilitate communication between cytopathologists and clinicians, and improve patient care. The WHO System describes 5 categories for reporting lung cytopathology: 'Insufficient/Inadequate/Nondiagnostic', 'Benign', 'Atypical', 'Suspicious for malignancy', and 'Malignant', each one with a clear descriptive term, a definition, a risk of malignancy, and a suggested management algorithm. The key diagnostic cytopathologic features of each of the lesions within each category have been established by consensus through an Expert Editorial Board, who are also the authors of this review and selected for each reporting system and chosen based on their expertise in the field and/or diversity of geographical representation. Many other co-authors from around the world also contributed. The assignment of writing and editing responsibilities used the same model as that used for the WHO Classification of Tumours (https://whobluebooks.iarc.fr/about/faq/). The WHO System provides the best practice application of ancillary testing, including immunocytochemistry and molecular pathology, and guides in sampling and processing techniques to optimize the handling and preparation of specimens. The WHO System was created by the authors to be applicable globally and is based on cytomorphology with possibilities for additional diagnostic management of the patient. The authors are aware that local medical and pathology resources would differ, especially in low- and middle-income countries. The WHO Tumour Classification for Thoracic Tumors, Fifth Edition, is directly accessible through the online WHO System.
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Affiliation(s)
- Sule Canberk
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal; Abel Salazar Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal; IPATIMUP, Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal
| | - Andrew Field
- Department of Anatomical Pathology, St Vincent's Hospital, Sydney, and University of New South Wales Sydney and University of Notre Dame, Sydney, Australia
| | - Lukas Bubendorf
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Ashish Chandra
- Department of Cellular Pathology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Ian A Cree
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Marianne Engels
- Institute of Pathology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kenzo Hiroshima
- Department of Biochemistry and Genetics Chiba University Graduate School of Medicine, Chiba, Japan
| | - Deepali Jain
- Department of Pathology-All India Institute of Medical Sciences, New Delhi, India
| | - Ivana Kholová
- Pathology, Fimlab Laboratories and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Lester Layfield
- Pathology and Anatomic Science Department, University of Missouri, Columbia, Missouri
| | - Ravi Mehrotra
- Indian Cancer Genomic Atlas, Centre for Health, Innovation and Policy Foundation, Pune, India
| | - Claire Michael
- Department of Pathology, University Hospitals Cleveland Medical Center/Case, Western Reserve University, Cleveland, Ohio
| | - Robert Osamura
- Department of Diagnostic Pathology, Nippon Koukan Hospital, Kawasaki, Japan
| | - Martha B Pitman
- Department of Pathology, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts
| | - Sinchita Roy-Chowdhuri
- Division of Pathology and Laboratory Medicine, Department of Pathology, Molecular Diagnostics Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yukitoshi Satoh
- Department of Thoracic Surgery, Kitasato University School of Medicine, Tokio, Japan
| | - Paul VanderLaan
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | | | - Fernando C Schmitt
- IPATIMUP, Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal; Department of Pathology, Faculty of Medicine of University of Porto, Porto, Portugal; CINTESIS@RISE, Health Research Network, Porto, Portugal.
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Asif AA, Narula T, Erasmus DB, Alvarez F, Nichols T, Jacob S, Pham SM, Cortese C, Makey IA. Successful lung transplantation from a donor with lung and ovarian masses. J Surg Case Rep 2019; 2019:rjz307. [PMID: 31719970 PMCID: PMC6830262 DOI: 10.1093/jscr/rjz307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/08/2019] [Indexed: 11/25/2022] Open
Abstract
Declining a donor when there is a reasonable possibility that the abnormality on chest imaging could be benign carries the risk of losing out on potentially usable lungs in an already parched landscape of donor organ availability. Cautiously aggressive attitudes to acceptance of borderline donors can help bridge the significant discrepancy that exists between the demand and availability of donor organs. Herein, we present a case highlighting successful bilateral lung transplantation from a relatively imperfect donor.
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Affiliation(s)
- Abuzar A Asif
- Department of Transplantation, Mayo Clinic, Jacksonville, FL, USA
| | - Tathagat Narula
- Department of Transplantation, Mayo Clinic, Jacksonville, FL, USA
| | - David B Erasmus
- Department of Transplantation, Mayo Clinic, Jacksonville, FL, USA
| | | | - Todd Nichols
- Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Samuel Jacob
- Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Si M Pham
- Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Cherise Cortese
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
| | - Ian A Makey
- Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA
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Huang CC, Hung ST, Chang WC, Sheu CY. Benign features of infection-related tumor-like lesions of the lung: A retrospective imaging review study. J Med Imaging Radiat Oncol 2017; 61:481-488. [PMID: 28139094 DOI: 10.1111/1754-9485.12588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 12/14/2016] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Differentiation of benign and malignant pulmonary tumor-like lesions is challenging but increasingly important. We evaluate the most common imaging features in benign lesions based on the frequency of their appearance and compare with corresponding frequencies in malignant tumors from literature. METHODS Retrospective imaging review study in one center between 1 January 2012 and 30 June 2014. We reviewed the data from 2466 pathological examinations of lung specimens collected from the hospital. We excluded malignant or non-tumor-like lesions and identified 133 infection-related lesions for imaging review. The frequency of 11 benign imaging features was evaluated in the selected infection-related tumor-like pulmonary lesions and was compared with corresponding frequency in malignant tumors. RESULTS Most of the evaluated lesions were seen to have one to four benign features. The two most common benign features are marginal ground glass or infiltrates (62.4%), followed by pleura-based wedge shape (50.4%). Features with significantly higher frequency in benign infection-related lung lesions than malignancy are calcification or hyperdensity, pleura-based wedge shape, adjacent clustered small nodules, and strongly or poorly enhanced soft tissue part. CONCLUSIONS Infection-related lung lesions usually have one to four benign features and the common features with significantly higher frequency than malignant condition are pleura-based wedge shape, calcification or hyperdensity, adjacent clustered small nodules, and strongly or poorly enhanced soft tissue part.
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Affiliation(s)
- Chun-Chao Huang
- Department of Radiology, Mackay Memorial Hospital, Taipei Branch, Taipei, Taiwan.,Department of Medicine, Mackay Medical College, Taipei, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Sho-Ting Hung
- Department of Medicine, Mackay Medical College, Taipei, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.,Department of Radiology, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan
| | - Wei-Chin Chang
- Department of Pathology, Mackay Memorial Hospital, Taipei Branch, Taipei, Taiwan
| | - Chin-Yin Sheu
- Department of Radiology, Mackay Memorial Hospital, Taipei Branch, Taipei, Taiwan
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Kuempel ED, Jaurand MC, Møller P, Morimoto Y, Kobayashi N, Pinkerton KE, Sargent LM, Vermeulen RCH, Fubini B, Kane AB. Evaluating the mechanistic evidence and key data gaps in assessing the potential carcinogenicity of carbon nanotubes and nanofibers in humans. Crit Rev Toxicol 2017; 47:1-58. [PMID: 27537422 PMCID: PMC5555643 DOI: 10.1080/10408444.2016.1206061] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 06/22/2016] [Indexed: 12/31/2022]
Abstract
In an evaluation of carbon nanotubes (CNTs) for the IARC Monograph 111, the Mechanisms Subgroup was tasked with assessing the strength of evidence on the potential carcinogenicity of CNTs in humans. The mechanistic evidence was considered to be not strong enough to alter the evaluations based on the animal data. In this paper, we provide an extended, in-depth examination of the in vivo and in vitro experimental studies according to current hypotheses on the carcinogenicity of inhaled particles and fibers. We cite additional studies of CNTs that were not available at the time of the IARC meeting in October 2014, and extend our evaluation to include carbon nanofibers (CNFs). Finally, we identify key data gaps and suggest research needs to reduce uncertainty. The focus of this review is on the cancer risk to workers exposed to airborne CNT or CNF during the production and use of these materials. The findings of this review, in general, affirm those of the original evaluation on the inadequate or limited evidence of carcinogenicity for most types of CNTs and CNFs at this time, and possible carcinogenicity of one type of CNT (MWCNT-7). The key evidence gaps to be filled by research include: investigation of possible associations between in vitro and early-stage in vivo events that may be predictive of lung cancer or mesothelioma, and systematic analysis of dose-response relationships across materials, including evaluation of the influence of physico-chemical properties and experimental factors on the observation of nonmalignant and malignant endpoints.
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Affiliation(s)
- Eileen D Kuempel
- a National Institute for Occupational Safety and Health , Cincinnati , OH , USA
| | - Marie-Claude Jaurand
- b Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche , UMR 1162 , Paris , France
- c Labex Immuno-Oncology, Sorbonne Paris Cité, University of Paris Descartes , Paris , France
- d University Institute of Hematology, Sorbonne Paris Cité, University of Paris Diderot , Paris , France
- e University of Paris 13, Sorbonne Paris Cité , Saint-Denis , France
| | - Peter Møller
- f Department of Public Health , University of Copenhagen , Copenhagen , Denmark
| | - Yasuo Morimoto
- g Department of Occupational Pneumology , University of Occupational and Environmental Health , Kitakyushu City , Japan
| | | | - Kent E Pinkerton
- i Center for Health and the Environment, University of California , Davis , California , USA
| | - Linda M Sargent
- j National Institute for Occupational Safety and Health , Morgantown , West Virginia , USA
| | - Roel C H Vermeulen
- k Institute for Risk Assessment Sciences, Utrecht University , Utrecht , The Netherlands
| | - Bice Fubini
- l Department of Chemistry and "G.Scansetti" Interdepartmental Center , Università degli Studi di Torino , Torino , Italy
| | - Agnes B Kane
- m Department of Pathology and Laboratory Medicine , Brown University , Providence , RI , USA
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Wang M, Liu Y, Li D, Xiong C, Qian X, Tang Y. Endobronchial fibroma in a pneumoconiosis patient with a history of tuberculosis: A case report and literature review. Oncol Lett 2016; 12:1041-1045. [PMID: 27446391 DOI: 10.3892/ol.2016.4726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/01/2016] [Indexed: 12/31/2022] Open
Abstract
Bronchial fibroma is uncommon, with only 18 cases reported since 1948. The current study presents a rare case of endobronchial fibroma, along with a relevant literature review. A 54-year-old male patient with pneumoconiosis and a history of tuberculosis was admitted to the Taihe Hospital Affiliated With Hubei University of Medicine, Shiyan, China, due to refractory dry cough. Computed tomography of the chest showed multiple nodular and confluent opacities in the lung and one cavitation in the right upper lobe region. Bronchoscopy revealed an endobronchial mass in the left main bronchus. A bronchoscopic resection was performed, and the pathological evaluation confirmed fibroma. The patient's dry cough resolved following the removal of the fibroma, and no recurrence was detected during 6 months of follow-up. Endobronchial fibroma is an extremely rare disease, for which a pathological analysis is typically required for an accurate diagnosis. Bronchoscopic treatments, including removal by forceps, argon plasma coagulation and laser or electrocautery snares, may be used to treat patients affected by endobronchial fibroma.
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Affiliation(s)
- Meifang Wang
- Department of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China; Institute of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Yuquan Liu
- Department of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China; Institute of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Dan Li
- Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Chang Xiong
- Department of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China; Institute of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Xin Qian
- Department of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China; Institute of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Yijun Tang
- Department of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China; Institute of Respiratory Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
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Casalini E, Cavazza A, Andreani A, Marchioni A, Montanari G, Cappiello FG, Mengoli MC, Corradini P, Agostini L, Serini R, Rossi G. Bronchial fibroepithelial polyp: a clinico-radiologic, bronchoscopic, histopathological and in-situ hybridisation study of 15 cases of a poorly recognised lesion. CLINICAL RESPIRATORY JOURNAL 2015; 11:43-48. [PMID: 25832329 DOI: 10.1111/crj.12300] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 03/02/2015] [Accepted: 03/23/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Bronchial fibroepithelial polyp is an uncommon, poorly recognised lesion, lacking clear diagnostic criteria at histology, but possibly mimicking neoplastic growth on clinico-radiologic and histopathological grounds. The aim of this study was to define the clinico-pathological features, bronchoscopic appearance and treatment of bronchial fibroepithelial polyp. METHODS We collected the largest series of bronchial fibroepithelial polyps (15 consecutive cases), including clinico-pathological, bronchoscopic, radiologic and histological features. RESULTS Overall, there were 13 males and 2 females, with a mean age of 68 years at diagnosis. Eight patients were asymptomatic, whereas four presented with haemoptysis, two with fever, cough and pneumonia-like opacity, and one with dry recurrent cough. Mean size of the lesion was 6.5 mm (range, 2-20 mm) without any prevalence for segmental bronchi. Lesions larger than 10 mm were always symptomatic and visible at computed tomography scans. At bronchoscopy, the lesion appeared as a firm endobronchial nodule with hard consistency and glistening, whitish, smooth surface. A multilobulated and sepimentated surface was observed in the largest polyps. Whatever the size, histological features were quite similar in all cases, consisting in a polypoid lesion with a dense, collagenous, hypocellular stroma with some thin-walled, ectatic vessels and a regular respiratory mucosa on surface. In-situ hybridisation with human papillomavirus probe was negative in all the eight tested cases. CONCLUSION Despite the benign behaviour of bronchial fibroepithelial polyps, it is important to fix some robust diagnostic criteria in order to avoid misdiagnoses leading to unnecessary aggressive treatment. Differential diagnosis mainly includes inflammatory polyps, hamartomas and papillomas.
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Affiliation(s)
- Eleonora Casalini
- Department of Oncology and Haematology, Respiratory Diseases Clinic, University Hospital Policlinico of Modena, Modena, Italy
| | - Alberto Cavazza
- Department of Oncology and Advanced Technologies, Operative Unit of Pathologic Anatomy, Azienda Arcispedale S. Maria Nuova/IRCCS, Reggio Emilia, Italy
| | | | - Alessandro Marchioni
- Department of Oncology and Haematology, Respiratory Diseases Clinic, University Hospital Policlinico of Modena, Modena, Italy
| | - Gloria Montanari
- Department of Oncology and Haematology, Respiratory Diseases Clinic, University Hospital Policlinico of Modena, Modena, Italy
| | | | - Maria Cecilia Mengoli
- Department of Diagnostic Laboratories, Section of Pathologic Anatomy, University Hospital Policlinico of Modena, Modena, Italy
| | - Paolo Corradini
- Department of Oncology and Haematology, Respiratory Diseases Clinic, University Hospital Policlinico of Modena, Modena, Italy
| | - Lorenzo Agostini
- Operative Unit of Pulmonology, Azienda Arcispedale S. Maria Nuova/IRCCS, Reggio Emilia, Italy
| | - Roberto Serini
- Operative Unit of Pulmonology, Civic Hospital, Sassuolo, Italy
| | - Giulio Rossi
- Department of Diagnostic Laboratories, Section of Pathologic Anatomy, University Hospital Policlinico of Modena, Modena, Italy
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Joshi HMN, Page RD. Giant pulmonary hamartoma causing acute right heart failure. Ann Thorac Surg 2014; 97:e21-2. [PMID: 24384217 DOI: 10.1016/j.athoracsur.2013.07.099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 06/15/2013] [Accepted: 07/22/2013] [Indexed: 11/26/2022]
Abstract
Giant pulmonary hamartomas are rare. We describe a case of a 59-year-old female patient with a giant chondroid hamartoma in the lower lobe of the right lung presenting with acute right heart failure. To the best of our knowledge such a unique presentation has not been previously described in the literature.
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Affiliation(s)
- Heman M N Joshi
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.
| | - Richard D Page
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
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