Lepidic predominant adenocarcinoma of the lung

Discussion:

This patient went on to have a left upper lobectomy. 

Histology

MICROSCOPIC DESCRIPTION: Sections from the tumor show adenocarcinoma with a predominantly lepidic growth (60%) and a lesser component of acinar growth (40%). Tumor cells are cuboidal to columnar with large hyperchromatic pleomorphic, small nucleoli and clumped chromatin. The stroma appears desmoplastic and contains a dense mononuclear inflamamtory cell infiltrate. There is a large central scar area. Lymphovascular and perineural invasion are not identified. Tumor is close to the pleura. but does not appear to invade the pleura. The sections of the hilar margin structures are clear of tumor. Lung parenchyma away from the tumor is unremarkable. There is some mild subpleural fibrosis and emphysema in one of the sections. Two lymph nodes show no evidence of metastatic carcinoma. 

DIAGNOSIS:

  1. Left upper lobectomy: * Lepidic predominant adenocarcinoma. - Lepidic component 60%, acinar component 40%. - Size - 22mm. - No pleural invasion. - No lymphovascular invasion. - No perineural invasion. - Well clear of margins. - 2 lymph nodes with no evidence of metastatic carcinoma (0/2).
  2. Station 5, 8, 10, 11: lymph nodes with no evidence of metastatic carcinoma 
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