Alessandra Cancellieri - Academia.edu (original) (raw)
Papers by Alessandra Cancellieri
Atlas of Diffuse Lung Diseases, 2016
Atlas of Diffuse Lung Diseases, 2016
Atlas of Diffuse Lung Diseases, 2016
Frontiers in Oncology, 2021
Large-cell neuroendocrine carcinomas of the lung (LCNECs) are rare tumors representing 1–3% of al... more Large-cell neuroendocrine carcinomas of the lung (LCNECs) are rare tumors representing 1–3% of all primary lung cancers. Patients with LCNEC are predominantly male, older, and heavy smokers. Histologically, these tumors are characterized by large cells with abundant cytoplasm, high mitotic rate, and neuroendocrine immunohistochemistry-detected markers (chromogranin-A, synaptophysin, and CD56). In 2015 the World Health Organization classified LCNEC as a distinct subtype of pulmonary large-cell carcinoma and, therefore, as a subtype of non-small cell lung carcinoma (NSCLC). Because of the small-sized tissue samples and the likeness to other neuroendocrine tumors, the histological diagnosis of LCNEC remains difficult. Clinically, the prognosis of metastatic LCNECs is poor, with high rates of recurrence after surgery alone and overall survival of approximately 35% at 5 years, even for patients with early stage disease that is dramatically shorter compared with other NSCLC subtypes. Firs...
European Respiratory Journal, 2020
Respiration, 2021
Background: Diagnosis, staging, and molecular profiling of lung cancer are mostly carried out wit... more Background: Diagnosis, staging, and molecular profiling of lung cancer are mostly carried out with bronchoscopy or CT-guided aspiration/biopsy. However, patients with locally advanced or advanced disease often harbor “superficial” metastases for which a percutaneous, ultrasound-assisted needle aspiration/biopsy (US-NAB) might represent an equally effective yet less invasive and costly alternative. Patients and Methods: We reviewed a prospectively collected database of consecutive patients with known/suspected lung cancer who underwent a US-NAB of a suspected “superficial” metastasis. Cancer genotyping was carried out with next-generation sequencing using the Oncomine™ Focus DNA and RNA fusion panels. PD-L1 immunohistochemistry was performed with the SP263 antibody. Feasibility, diagnostic yield for tissue diagnosis, sensitivity for malignancy, diagnostic yield for the molecular profiling, and complications were the study endpoints. Results: A total of 98 lesions were evaluated, and ...
Lung Cancer, 2020
INTRODUCTION Pulmonary adenocarcinoma with psammoma bodies (PAPBs) is a rare histological variant... more INTRODUCTION Pulmonary adenocarcinoma with psammoma bodies (PAPBs) is a rare histological variant whose association with a high prevalence of targetable mutations has been suggested by scant literature reports describing small series. We aim to describe the endobronchial ultrasound (EBUS) pattern and the molecular profile by next-generation sequencing of an Italian series of patients with PAPBs. MATERIAL AND METHODS Over a 8-year period (2012-2019), we identified 15 patients with a very uncommon endobronchial ultrasound (EBUS) heterogeneity pattern characterized by the presence of multiple to countless, punctate non-shadowing foci ("starry sky" sign) which were not evident at CT and corresponded to psammoma bodies at pathological examination. The clinical, radiological, pathological and molecular findings of these patients were retrieved and analyzed. RESULTS Pathological examination of the EBUS-TBNA specimens revealed malignancy (12 pulmonary adenocarcinoma, 2 breast carcinoma, 1 colonic carcinoma) and showed the presence of psammoma bodies in all of the 15 patients with the starry sky sign. Among the 12 patients with pulmonary adenocarcinoma with psammoma bodies, female sex (8/12, 66.7 %) and never-smoking habit (6/12, 50 %) were prevalent. Molecular tumor profiling using the Oncomine™ Focus DNA and RNA fusion panels was successfully performed in 11/12 patients and revealed 10 genetic alterations (BRAF mutation, 4; EGFR mutation, 2; ALK rearrangement, RET rearrangement, PIK3CA mutation, CDK4 amplification 1) in 7 patients (63.6 %). CONCLUSION The present series suggests that pulmonary adenocarcinoma with psammoma bodies is associated with a readily identifiable EBUS pattern and with a high prevalence of different, often uncommon and actionable, driver mutations.
The Clinical Respiratory Journal, 2019
BJR|case reports, 2019
Pleuroparenchymal fibroelastosis (PPFE) is a very rare lung disease characterized by dense fibrou... more Pleuroparenchymal fibroelastosis (PPFE) is a very rare lung disease characterized by dense fibrous thickening of the visceral pleura and intra alveolar fibrosis containing prominent elastosis, with typical upper lobe predominance. PPFE usually shows progressive restrictive ventilatory impairment refractory to medical treatment; bilateral lung transplantation currently remains the only available therapeutic option. In this report we describe a case of suspected PPFE relapse after lung transplantation that, to our knowledge, has never been described in the medical literature. A 48-year-old male with Idiopathic Pleuroparenchymal Fibroelastosis (iPPFE) underwent a bilateral lung transplant in our Department. Eight months later, he presented with progressively worsening clinical condition, his respiratory state gradually deteriorated. HRCT again showed bilateral diffused parenchymal consolidations, with prevalence in the upper lobes and subpleural regions. A PPFE relapse was therefore su...
Respiration, 2019
Background: The widespread use of rapid on-site evaluation is hampered by constraints related to ... more Background: The widespread use of rapid on-site evaluation is hampered by constraints related to time and resources, inadequate reimbursement, and evidence from randomized trials that show a lack of increase in diagnostic yield and specimen adequacy associated with its usage. Objective: We aimed to verify whether a pulmonologist can assess endosonography-derived lymph node samples after a comprehensive and reproducible training provided by a specialist pathologist. Methods:Prospective, observational trial structured in three phases. In the first (training) phase, a pathologist critically evaluated the smears from 150 archival endosonography cases with a pulmonologist. In the second (test) phase, the pulmonologist was asked to assess 50 archival endosonography-derived samples. In the last (real-life) phase, the pulmonologist classified the samples from 200 patients during the endosonography. The overall agreement between pulmonologist and pathologist (gold standard), assessed through κ-statistics, was the primary outcome. The agreement for the identification of specific cytological categories was the secondary outcome. Results: The overallagreement between pulmonologist and pathologist was 84% (κ0.765, 95% CI 0.732–0.826) in the test phase and 89.7% (κ 0.844, 95% CI 0.799–0.881) in the real-life phase. The agreement for specific cytological categories was 92.7% (95% CI 0.824–0.980) for inadequate samples, 90.3% (95% CI 84.5–94.5%) for reactive lymphadenopathies, 90.5% (95% CI 0.845–0.946) for malignancy, and 73% (95% CI 0.515–0.897) for granulomatous samples. Conclusions: A trained pulmonologist can reliably assess adequacy and malignancy for endosonography-derived samples, which could be useful in institutions where a cytopathologist/cytotechnician is not available regularly.
The Annals of Thoracic Surgery, 2019
American Journal of Respiratory and Critical Care Medicine, 2019
Rationale: The diagnostic concordance between transbronchial lung cryobiopsy (TBLC)-versus surgic... more Rationale: The diagnostic concordance between transbronchial lung cryobiopsy (TBLC)-versus surgical lung biopsy (SLB) as the current gold standard-in interstitial lung disease (ILD) cases requiring histology remains controversial. Objectives: To assess diagnostic concordance between TBLC and SLB sequentially performed in the same patients, the diagnostic yield of both techniques, and subsequent changes in multidisciplinary assessment (MDA) decisions. Methods: A two-center prospective study included patients with ILD with a nondefinite usual interstitial pneumonia pattern (on highresolution computed tomography scan) confirmed at a first MDA. Patients underwent TBLC immediately followed by video-assisted thoracoscopy for SLB at the same anatomical locations. After open reading of both sample types by local pathologists and final diagnosis at a second MDA (MDA2), anonymized TBLC and SLB slides were blindly assessed by an external expert pathologist (T.V.C.). Kappaconcordance coefficients and percentage agreement were computed for: TBLC versus SLB, MDA2 versus TBLC, MDA2 versus SLB, and blinded pathology versus routine pathology. Measurements and Main Results: Twenty-one patients were included. The median TBLC biopsy size (longest axis) was 7 mm (interquartile range, 5-8 mm). SLB biopsy sizes averaged 46.1 6 13.8 mm. Concordance coefficients and percentage agreement were: TBLC versus SLB: k = 0.22 (95% confidence interval [CI], 0.01-0.44), percentage agreement = 38% (95% CI, 18-62%); MDA2 versus TBLC: k = 0.31 (95% CI, 0.06-0.56), percentage agreement = 48% (95% CI, 26-70)%; MDA2 versus SLB: k = 0.51 (95% CI, 0.27-0.75), percentage agreement = 62% (95% CI, 38-82%); two pneumothoraces (9.5%) were recorded during TBLC. TBLC would have led to a different treatment if SLB was not performed in 11 of 21 (52%) of cases. Conclusions: Pathological results from TBLC and SLB were poorly concordant in the assessment of ILD. SLBs were more frequently concordant with the final diagnosis retained at MDA.
International journal of surgery case reports, Jan 31, 2018
The diagnostic approach to patients with mediastinal pathology is not always simple and an improp... more The diagnostic approach to patients with mediastinal pathology is not always simple and an improper diagnostic work-up can lead to significant diagnosis delay. We report on the case of a young woman who was admitted to the Emergency Department complaining of thoracic pain, dyspnoea, fever and productive cough. The physical examination showed a painful swelling over the sternum's upper left margin, which had become evident 4 months earlier. A Computer Tomography showed the presence of a retrosternal oval lesion (5.5 x 4 cm) infiltrating the thoracic wall and showed the presence of discretely enlarged mediastinal lymph nodes in several mediastinal stations. The Multidisciplinary Team decided to perform an ultrasound-guided biopsy of the retrosternal mass that showed an inflammatory pattern, whereas microbiology tests proved negative. The lack of improvement with medical therapy (non steroideal anti-inflammatories and antibiotics) and the clinical suspicion of malignancy led us to ...
The clinical respiratory journal, Jan 4, 2017
Endosonography has become standard of care in the diagnostic work-up of mediastinal lymphadenopat... more Endosonography has become standard of care in the diagnostic work-up of mediastinal lymphadenopathy and peribronchial lung lesions, but its success rate in some specific settings/conditions may be hampered by limited needle flexibility and size. We report on our initial experience with the 19G Flex needle, characterized by larger size and greater flexibility as compared with the currently available cytology needles. Retrospective review of prospectively collected data on the first 13 consecutive patients submitted to endosonography with the 19G Flex needle. Patients were included if they had: (a) suspicion of a histologically complex disease (ie, lymphoma); (b) suspicion of an advanced lung cancer possibly requiring extensive genotyping; (c) a lesion whose sampling with a 22G needle had failed because of lack of visibility when the needle was loaded into the scope. The 13 patients enrolled had a mean age of 58.15 ± 17 years and a male to female ratio of 8:5. Target lesions (mean siz...
Annals of translational medicine, 2017
Synchronous cancers are not such rare clinical conditions. Nevertheless, even after the 8th editi... more Synchronous cancers are not such rare clinical conditions. Nevertheless, even after the 8th edition of the TNM classification of the lung cancer, the surgical approach for patients presenting with synchronous bilateral lung cancer is still under debate. The resection of both lesions in the case of synchronous bilateral lung cancer is reasonable, but, on the other hand, is the lobectomy the correct choice in the event of the single primary with a contralateral metastatic lesion? In this case report, we describe how the molecular analysis and the detection of theandmutations in both tumours have determined in a patient the two tumours as primary and both the right surgical approach. We also discuss how molecular analysis found differences in all the three genes examined in the two lesions and allowed to exclude the clonal nature of the two tumours. In conclusion, genetic studies help to offer a more radical surgical treatment to this patient.
Histopathology, Jan 30, 2017
The association between lung cancer and idiopathic pulmonary fibrosis (IPF) is well-known, howeve... more The association between lung cancer and idiopathic pulmonary fibrosis (IPF) is well-known, however the significance of this association is poorly understood. Bronchiolar honeycomb cysts have been proposed as possible precursors for development of carcinoma, but limited evidence of this hypothesis is available. Thirty-three lung carcinomas arising in patients with IPF have been analyzed using a panel of immunohistochemical markers. The antibodies included pneumocyte markers (TTF1, Napsin-A, SPA1), the goblet cell marker MUC5AC, markers of basal/squamous cell differentiation (CK5/6, ΔN-p63) and markers related to enteric differentiation (CDX2, MUC2, CK20, villin). A series of 100 consecutive lung adenocarcinomas arising in smokers without IPF was investigated as control. All carcinomas arising in IPF were peripherally located at imaging analysis. The diagnosis were: 8 squamous cell carcinomas, 20 adenocarcinomas, 3 small-cell carcinomas (including one composite small-cell and adenocar...
Atlas of Diffuse Lung Diseases, 2016
Atlas of Diffuse Lung Diseases, 2016
Diffuse lung diseases (DLDs) are a heterogeneous group of lung disorders, consisting of inflammat... more Diffuse lung diseases (DLDs) are a heterogeneous group of lung disorders, consisting of inflammation and/or fibrosis of the pulmonary parenchyma, classified together because of some similar clinical, radiographic, physiologic or pathologic manifestations.
Atlas of Diffuse Lung Diseases, 2016
Atlas of Diffuse Lung Diseases, 2016
Atlas of Diffuse Lung Diseases, 2016
Frontiers in Oncology, 2021
Large-cell neuroendocrine carcinomas of the lung (LCNECs) are rare tumors representing 1–3% of al... more Large-cell neuroendocrine carcinomas of the lung (LCNECs) are rare tumors representing 1–3% of all primary lung cancers. Patients with LCNEC are predominantly male, older, and heavy smokers. Histologically, these tumors are characterized by large cells with abundant cytoplasm, high mitotic rate, and neuroendocrine immunohistochemistry-detected markers (chromogranin-A, synaptophysin, and CD56). In 2015 the World Health Organization classified LCNEC as a distinct subtype of pulmonary large-cell carcinoma and, therefore, as a subtype of non-small cell lung carcinoma (NSCLC). Because of the small-sized tissue samples and the likeness to other neuroendocrine tumors, the histological diagnosis of LCNEC remains difficult. Clinically, the prognosis of metastatic LCNECs is poor, with high rates of recurrence after surgery alone and overall survival of approximately 35% at 5 years, even for patients with early stage disease that is dramatically shorter compared with other NSCLC subtypes. Firs...
European Respiratory Journal, 2020
Respiration, 2021
Background: Diagnosis, staging, and molecular profiling of lung cancer are mostly carried out wit... more Background: Diagnosis, staging, and molecular profiling of lung cancer are mostly carried out with bronchoscopy or CT-guided aspiration/biopsy. However, patients with locally advanced or advanced disease often harbor “superficial” metastases for which a percutaneous, ultrasound-assisted needle aspiration/biopsy (US-NAB) might represent an equally effective yet less invasive and costly alternative. Patients and Methods: We reviewed a prospectively collected database of consecutive patients with known/suspected lung cancer who underwent a US-NAB of a suspected “superficial” metastasis. Cancer genotyping was carried out with next-generation sequencing using the Oncomine™ Focus DNA and RNA fusion panels. PD-L1 immunohistochemistry was performed with the SP263 antibody. Feasibility, diagnostic yield for tissue diagnosis, sensitivity for malignancy, diagnostic yield for the molecular profiling, and complications were the study endpoints. Results: A total of 98 lesions were evaluated, and ...
Lung Cancer, 2020
INTRODUCTION Pulmonary adenocarcinoma with psammoma bodies (PAPBs) is a rare histological variant... more INTRODUCTION Pulmonary adenocarcinoma with psammoma bodies (PAPBs) is a rare histological variant whose association with a high prevalence of targetable mutations has been suggested by scant literature reports describing small series. We aim to describe the endobronchial ultrasound (EBUS) pattern and the molecular profile by next-generation sequencing of an Italian series of patients with PAPBs. MATERIAL AND METHODS Over a 8-year period (2012-2019), we identified 15 patients with a very uncommon endobronchial ultrasound (EBUS) heterogeneity pattern characterized by the presence of multiple to countless, punctate non-shadowing foci ("starry sky" sign) which were not evident at CT and corresponded to psammoma bodies at pathological examination. The clinical, radiological, pathological and molecular findings of these patients were retrieved and analyzed. RESULTS Pathological examination of the EBUS-TBNA specimens revealed malignancy (12 pulmonary adenocarcinoma, 2 breast carcinoma, 1 colonic carcinoma) and showed the presence of psammoma bodies in all of the 15 patients with the starry sky sign. Among the 12 patients with pulmonary adenocarcinoma with psammoma bodies, female sex (8/12, 66.7 %) and never-smoking habit (6/12, 50 %) were prevalent. Molecular tumor profiling using the Oncomine™ Focus DNA and RNA fusion panels was successfully performed in 11/12 patients and revealed 10 genetic alterations (BRAF mutation, 4; EGFR mutation, 2; ALK rearrangement, RET rearrangement, PIK3CA mutation, CDK4 amplification 1) in 7 patients (63.6 %). CONCLUSION The present series suggests that pulmonary adenocarcinoma with psammoma bodies is associated with a readily identifiable EBUS pattern and with a high prevalence of different, often uncommon and actionable, driver mutations.
The Clinical Respiratory Journal, 2019
BJR|case reports, 2019
Pleuroparenchymal fibroelastosis (PPFE) is a very rare lung disease characterized by dense fibrou... more Pleuroparenchymal fibroelastosis (PPFE) is a very rare lung disease characterized by dense fibrous thickening of the visceral pleura and intra alveolar fibrosis containing prominent elastosis, with typical upper lobe predominance. PPFE usually shows progressive restrictive ventilatory impairment refractory to medical treatment; bilateral lung transplantation currently remains the only available therapeutic option. In this report we describe a case of suspected PPFE relapse after lung transplantation that, to our knowledge, has never been described in the medical literature. A 48-year-old male with Idiopathic Pleuroparenchymal Fibroelastosis (iPPFE) underwent a bilateral lung transplant in our Department. Eight months later, he presented with progressively worsening clinical condition, his respiratory state gradually deteriorated. HRCT again showed bilateral diffused parenchymal consolidations, with prevalence in the upper lobes and subpleural regions. A PPFE relapse was therefore su...
Respiration, 2019
Background: The widespread use of rapid on-site evaluation is hampered by constraints related to ... more Background: The widespread use of rapid on-site evaluation is hampered by constraints related to time and resources, inadequate reimbursement, and evidence from randomized trials that show a lack of increase in diagnostic yield and specimen adequacy associated with its usage. Objective: We aimed to verify whether a pulmonologist can assess endosonography-derived lymph node samples after a comprehensive and reproducible training provided by a specialist pathologist. Methods:Prospective, observational trial structured in three phases. In the first (training) phase, a pathologist critically evaluated the smears from 150 archival endosonography cases with a pulmonologist. In the second (test) phase, the pulmonologist was asked to assess 50 archival endosonography-derived samples. In the last (real-life) phase, the pulmonologist classified the samples from 200 patients during the endosonography. The overall agreement between pulmonologist and pathologist (gold standard), assessed through κ-statistics, was the primary outcome. The agreement for the identification of specific cytological categories was the secondary outcome. Results: The overallagreement between pulmonologist and pathologist was 84% (κ0.765, 95% CI 0.732–0.826) in the test phase and 89.7% (κ 0.844, 95% CI 0.799–0.881) in the real-life phase. The agreement for specific cytological categories was 92.7% (95% CI 0.824–0.980) for inadequate samples, 90.3% (95% CI 84.5–94.5%) for reactive lymphadenopathies, 90.5% (95% CI 0.845–0.946) for malignancy, and 73% (95% CI 0.515–0.897) for granulomatous samples. Conclusions: A trained pulmonologist can reliably assess adequacy and malignancy for endosonography-derived samples, which could be useful in institutions where a cytopathologist/cytotechnician is not available regularly.
The Annals of Thoracic Surgery, 2019
American Journal of Respiratory and Critical Care Medicine, 2019
Rationale: The diagnostic concordance between transbronchial lung cryobiopsy (TBLC)-versus surgic... more Rationale: The diagnostic concordance between transbronchial lung cryobiopsy (TBLC)-versus surgical lung biopsy (SLB) as the current gold standard-in interstitial lung disease (ILD) cases requiring histology remains controversial. Objectives: To assess diagnostic concordance between TBLC and SLB sequentially performed in the same patients, the diagnostic yield of both techniques, and subsequent changes in multidisciplinary assessment (MDA) decisions. Methods: A two-center prospective study included patients with ILD with a nondefinite usual interstitial pneumonia pattern (on highresolution computed tomography scan) confirmed at a first MDA. Patients underwent TBLC immediately followed by video-assisted thoracoscopy for SLB at the same anatomical locations. After open reading of both sample types by local pathologists and final diagnosis at a second MDA (MDA2), anonymized TBLC and SLB slides were blindly assessed by an external expert pathologist (T.V.C.). Kappaconcordance coefficients and percentage agreement were computed for: TBLC versus SLB, MDA2 versus TBLC, MDA2 versus SLB, and blinded pathology versus routine pathology. Measurements and Main Results: Twenty-one patients were included. The median TBLC biopsy size (longest axis) was 7 mm (interquartile range, 5-8 mm). SLB biopsy sizes averaged 46.1 6 13.8 mm. Concordance coefficients and percentage agreement were: TBLC versus SLB: k = 0.22 (95% confidence interval [CI], 0.01-0.44), percentage agreement = 38% (95% CI, 18-62%); MDA2 versus TBLC: k = 0.31 (95% CI, 0.06-0.56), percentage agreement = 48% (95% CI, 26-70)%; MDA2 versus SLB: k = 0.51 (95% CI, 0.27-0.75), percentage agreement = 62% (95% CI, 38-82%); two pneumothoraces (9.5%) were recorded during TBLC. TBLC would have led to a different treatment if SLB was not performed in 11 of 21 (52%) of cases. Conclusions: Pathological results from TBLC and SLB were poorly concordant in the assessment of ILD. SLBs were more frequently concordant with the final diagnosis retained at MDA.
International journal of surgery case reports, Jan 31, 2018
The diagnostic approach to patients with mediastinal pathology is not always simple and an improp... more The diagnostic approach to patients with mediastinal pathology is not always simple and an improper diagnostic work-up can lead to significant diagnosis delay. We report on the case of a young woman who was admitted to the Emergency Department complaining of thoracic pain, dyspnoea, fever and productive cough. The physical examination showed a painful swelling over the sternum's upper left margin, which had become evident 4 months earlier. A Computer Tomography showed the presence of a retrosternal oval lesion (5.5 x 4 cm) infiltrating the thoracic wall and showed the presence of discretely enlarged mediastinal lymph nodes in several mediastinal stations. The Multidisciplinary Team decided to perform an ultrasound-guided biopsy of the retrosternal mass that showed an inflammatory pattern, whereas microbiology tests proved negative. The lack of improvement with medical therapy (non steroideal anti-inflammatories and antibiotics) and the clinical suspicion of malignancy led us to ...
The clinical respiratory journal, Jan 4, 2017
Endosonography has become standard of care in the diagnostic work-up of mediastinal lymphadenopat... more Endosonography has become standard of care in the diagnostic work-up of mediastinal lymphadenopathy and peribronchial lung lesions, but its success rate in some specific settings/conditions may be hampered by limited needle flexibility and size. We report on our initial experience with the 19G Flex needle, characterized by larger size and greater flexibility as compared with the currently available cytology needles. Retrospective review of prospectively collected data on the first 13 consecutive patients submitted to endosonography with the 19G Flex needle. Patients were included if they had: (a) suspicion of a histologically complex disease (ie, lymphoma); (b) suspicion of an advanced lung cancer possibly requiring extensive genotyping; (c) a lesion whose sampling with a 22G needle had failed because of lack of visibility when the needle was loaded into the scope. The 13 patients enrolled had a mean age of 58.15 ± 17 years and a male to female ratio of 8:5. Target lesions (mean siz...
Annals of translational medicine, 2017
Synchronous cancers are not such rare clinical conditions. Nevertheless, even after the 8th editi... more Synchronous cancers are not such rare clinical conditions. Nevertheless, even after the 8th edition of the TNM classification of the lung cancer, the surgical approach for patients presenting with synchronous bilateral lung cancer is still under debate. The resection of both lesions in the case of synchronous bilateral lung cancer is reasonable, but, on the other hand, is the lobectomy the correct choice in the event of the single primary with a contralateral metastatic lesion? In this case report, we describe how the molecular analysis and the detection of theandmutations in both tumours have determined in a patient the two tumours as primary and both the right surgical approach. We also discuss how molecular analysis found differences in all the three genes examined in the two lesions and allowed to exclude the clonal nature of the two tumours. In conclusion, genetic studies help to offer a more radical surgical treatment to this patient.
Histopathology, Jan 30, 2017
The association between lung cancer and idiopathic pulmonary fibrosis (IPF) is well-known, howeve... more The association between lung cancer and idiopathic pulmonary fibrosis (IPF) is well-known, however the significance of this association is poorly understood. Bronchiolar honeycomb cysts have been proposed as possible precursors for development of carcinoma, but limited evidence of this hypothesis is available. Thirty-three lung carcinomas arising in patients with IPF have been analyzed using a panel of immunohistochemical markers. The antibodies included pneumocyte markers (TTF1, Napsin-A, SPA1), the goblet cell marker MUC5AC, markers of basal/squamous cell differentiation (CK5/6, ΔN-p63) and markers related to enteric differentiation (CDX2, MUC2, CK20, villin). A series of 100 consecutive lung adenocarcinomas arising in smokers without IPF was investigated as control. All carcinomas arising in IPF were peripherally located at imaging analysis. The diagnosis were: 8 squamous cell carcinomas, 20 adenocarcinomas, 3 small-cell carcinomas (including one composite small-cell and adenocar...
Atlas of Diffuse Lung Diseases, 2016
Atlas of Diffuse Lung Diseases, 2016
Diffuse lung diseases (DLDs) are a heterogeneous group of lung disorders, consisting of inflammat... more Diffuse lung diseases (DLDs) are a heterogeneous group of lung disorders, consisting of inflammation and/or fibrosis of the pulmonary parenchyma, classified together because of some similar clinical, radiographic, physiologic or pathologic manifestations.