New Entities in Smoking Related Lung Disease

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Journal of Thoracic Oncology 2011; 6: 244-285 Pathology Recommendation 1 • “We recommend discontinuing the use of the term “BAC” – Five situations where it is used: • Current WHO definition (lacks invasion) • Lesions with small regions of invasion • Lesions with predominant surface growth but central invasive component • Lesions with prominent invasive component and peripheral alveolar surface growth • In mucinous tumors (with invasion) Classification: Summary • Eliminate bronchioloalveolar carcinoma • Define adenocarcinoma in situ • Define minimally invasive adenocarcinoma • Resurrect the term “lepidic” • Promote comprehensive histologic subtyping • Emphasize micropapillary carcinoma • Detach mucinous adenocarcinomas • Discourage term NSCLC – subclassify if possible Journal of Thoracic Oncology. 6(2):244-285, February 2011. 5/28/2011 10
Pathology Recommendations 2/3 • Small (≤3 cm) solitary adenocarcinomas with pure lepidic growth termed adenocarcinoma in situ. • Small (≤3 cm) solitary adenocarcinomas with predominant lepidic growth and foci of invasion measuring ≤ 0.5 cm termed minimally invasive adenocarcinoma. Lepidic Growth • Maintains alveolar architecture – No destruction or effacement • No central or broad scar • Often has thickened alveolar septa • Cuboidal epithelium • Little to no stratification or tufting • No papillary structures 5/28/2011 11
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Page 3 and 4: The Military Experience • Analysi
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Page 7 and 8: Human Pathology 2010; 41: 316-325 S
Page 9: SRIF - Conclusions • Smoking can
Page 13 and 14: From Whence “Lepidic” • 1962:
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Page 17 and 18: Pathology Recommendation 9/10 • N
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New Entities in Smoking Related Lung Disease

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