The 2015 World Health Organization Classification of Tumors of the Pleura: Advances since the 2004 Classification  Francoise Galateau-Salle, MD, Andrew.

Slides:



Advertisements
Similar presentations
Proliferative Epithelial lesions of the Breast
Advertisements

The tumor appears as a fairly well circumscribed, pale, fleshy, homogeneous mass Seminoma of the testis.
A Malignant Case of Constrictive Pericarditis
Pulmonary hamartoma Here are two examples of a benign lung neoplasm known as a pulmonary hamartoma. These uncommon lesions appear on chest radiograph as.
Naomi Fujioka, MD, Christopher A. French, MD, Michael J
Acta Cytologica 2015;59: DOI: /
High-Grade Neuroendocrine Carcinoma with Bronchial Intraepithelial Tumor Spread  Hideaki Kojima, MD, Reiko Watanabe, MD, PhD, Mitsuhiro Isaka, MD, PhD,
The 2015 World Health Organization Classification of Lung Tumors
EGFR Status in Mesothelioma: Possible Implications for the Efficacy of Anti-EGFR and Anti-MET Therapies  Sandra Salvi, PhD, Serena Varesano, PhD, Simona.
Localized Malignant Pleural Mesothelioma: Report of Two Cases
Long-Term Survival in Two Cases of Resected Gastric Metastasis of Pulmonary Pleomorphic Carcinoma  Keiju Aokage, MD, Junji Yoshida, MD, Genichiro Ishii,
Jennelle C. Hodge, Patrick P. Bedroske, Kathryn E. Pearce, William R
FISH Analysis of Crizotinib Target Genes ROS1/ALK/MET in Malignant Mesothelioma  Sandra Salvi, PhD, Serena Varesano, PhD, Simona Boccardo, PhD, Jean Louis.
Sclerosing Pneumocytoma with Lymph Node Metastasis
A Sensitive ALK Immunohistochemistry Companion Diagnostic Test Identifies Patients Eligible for Treatment with Crizotinib  Trish Thorne-Nuzzo, BS, Crystal.
Molecular Analysis of Gene Fusions in Bone and Soft Tissue Tumors by Anchored Multiplex PCR–Based Targeted Next-Generation Sequencing  Suk Wai Lam, Anne-Marie.
Anja C. Roden, MD, Patricia T. Greipp, DO, Darlene L. Knutson, Sara M
Frequent Coamplification and Cooperation between C-MYC and PVT1 Oncogenes Promote Malignant Pleural Mesothelioma  Erick Riquelme, PhD, Milind B. Suraokar,
A Validation Study for the Use of ROS1 Immunohistochemical Staining in Screening for ROS1 Translocations in Lung Cancer  Patrizia Viola, MD, Manisha Maurya,
Primary Pulmonary NUT Midline Carcinoma: Clinical, Radiographic, and Pathologic Characterizations  Lynette M. Sholl, MD, Mizuki Nishino, MD, Saraswati.
Improving the Accuracy of Mesothelioma Diagnosis in China
MET and EGFR Mutations Identified in ALK-Rearranged Pulmonary Adenocarcinoma: Molecular Analysis of 25 ALK-Positive Cases  Jennifer M. Boland, MD, Jin.
Miliary Mesothelioma: A New Clinical and Radiological Presentation in Mesothelioma Patients with Prolonged Survival After Trimodality Therapy  Lesek Purek,
Muhammad Umair Khawar, MD, Bhaskar Bhardwaj, MD, Himanshu Bhardwaj, MD 
An Unusual Presentation of Malignant Pleural Mesothelioma
Pleomorphic Epithelioid Diffuse Malignant Pleural Mesothelioma: A Clinicopathological Review and Conceptual Proposal to Reclassify as Biphasic or Sarcomatoid.
Small Cell Transformation and T790M Mutation as Coresistance Mechanisms for First- line Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitor.
Comprehensive Hybrid Capture–Based Next-Generation Sequencing Identifies a Double ALK Gene Fusion in a Patient Previously Identified to Be False-Negative.
ALK and NRG1 Fusions Coexist in a Patient with Signet Ring Cell Lung Adenocarcinoma  Lucia Anna Muscarella, PhD, Domenico Trombetta, PhD, Federico Pio.
Why Do Pathological Stage IA Lung Adenocarcinomas Vary from Prognosis
A Case of Squamous Cell Carcinoma Harboring an EML4-ALK Rearrangement that Was Unsuccessfully Treated with the ALK Inhibitor Alectinib  Akihiro Tamiya,
Dual IHC and FISH Testing for ALK Gene Rearrangement in Lung Adenocarcinomas in a Routine Practice: A French Study  Anne McLeer-Florin, PhD, Denis Moro-Sibilot,
Combined Use of ALK Immunohistochemistry and FISH for Optimal Detection of ALK- Rearranged Lung Adenocarcinomas  Lynette M. Sholl, MD, Stanislawa Weremowicz,
A Sensitive ALK Immunohistochemistry Companion Diagnostic Test Identifies Patients Eligible for Treatment with Crizotinib  Trish Thorne-Nuzzo, BS, Crystal.
Does Lung Adenocarcinoma Subtype Predict Patient Survival
ALK Rearrangement Detected in a Focus of Pulmonary Atypical Adenomatous Hyperplasia  Filippo Lococo, MD, Alessandra Bisagni, MD, Maria Cecilia Mengoli,
Lung Metastases from Esophageal Granular Cell Tumor: An Undoubted Criterion for Malignancy  Isidro Machado, MD, PhD, Julia Cruz, MD, PhD, Estanislao Arana,
Adnan M. Al-Ayoubi, MD, Jonathan S. Ralston, MD, S
Radiologic Response to Neoadjuvant Treatment Predicts Histologic Response in Thymic Epithelial Tumors  Geoffrey B. Johnson, MD, PhD, Marie Christine Aubry,
Nicholas J. Olson, MD, David J. Finley, MD, Michael J
Mark L. Kayton, MD, Mai He, MD, PhD, Maureen F. Zakowski, MD, Andre L
Cardiac Sarcomas: An Update
Masahiko Kanamori, Cristina R. Antonescu, Melody Scott, Robert S
The neuropathology of brain metastases
MET Gene Status in Malignant Mesothelioma Using Fluorescent In Situ Hybridization  Serena Varesano, PhD, Sandra Salvi, PhD, Simona Boccardo, PhD, Jean.
BRCA1-Associated Protein 1 (BAP1) Immunohistochemical Expression as a Diagnostic Tool in Malignant Pleural Mesothelioma Classification: A Large Retrospective.
Role of Chromosome 3q Amplification in Lung Cancer
New IASLC/ATS/ERS Classification and Invasive Tumor Size are Predictive of Disease Recurrence in Stage I Lung Adenocarcinoma  Naoki Yanagawa, MD, PhD,
NUT Midline Carcinoma: An Aggressive Intrathoracic Neoplasm
Primary Malignant Pericardial Mesothelioma Mimicking Pericardial Metastasis from Adenocarcinoma  Masafumi Horie, MD, Satoshi Noguchi, MD, Wakae Tanaka,
An Unusual Cause of Pulmonary Nodules After Stem Cell Transplantation
Erratum Journal of Thoracic Oncology
NUT Rearrangement is Uncommon in Human Thymic Epithelial Tumors
Arnaud Uguen, MD, PhD  Journal of Thoracic Oncology 
A Case of ALK-Rearranged Adenocarcinoma with Small Cell Carcinoma-Like Transformation and Resistance to Crizotinib  Yoon Jin Cha, MD, PhD, Byoung Chul.
Amplification of MET in a Patient with Malignant Pleural Mesothelioma
Detection of ALK-Positive Non–Small-Cell Lung Cancers on Cytological Specimens: High Accuracy of Immunocytochemistry with the 5A4 Clone  Spasenija Savic,
An Unmet Need in the WHO 2015 Biopsy Classification: Poorly Differentiated NSCCs with Positive Neuroendocrine Markers  Jules L. Derks, MD  Journal of.
John R. Goldblum, MD, Thomas W. Rice, MD, Gregory Zuccaro, MD, Joel E
Validation of the IASLC/ATS/ERS Lung Adenocarcinoma Classification for Prognosis and Association with EGFR and KRAS Gene Mutations: Analysis of 440 Japanese.
MARIAMMA G. JOSEPH, M.D.  Mayo Clinic Proceedings 
Carlie S. Sigel, MD, Andre L. Moreira, MD, PhD, William D
Spontaneous Pneumothorax and Lung Carcinoma: Should One Consider Synchronous Malignant Pleural Mesothelioma?  Trevor A. Flood, MD, Harman S. Sekhon, MD,
Atypical Primary Epithelioid Hemangioendothelioma of the Heart
Immunohistochemistry is a Reliable Screening Tool for Identification of ALK Rearrangement in Non–Small-Cell Lung Carcinoma and is Antibody Dependent 
The α folate receptor is highly activated in malignant pleural mesothelioma  Raphael Bueno, MDa, Krishnarao Appasani, PhDa, Harriet Mercer, BSa, Susan.
Concomitant Epidermal Growth Factor Receptor Mutation and EML4-ALK Fusion in a Patient with Multifocal Lung Adenocarcinomas  Jun Fan, MD  Journal of Thoracic.
A Pathological Complete Response in Malignant Pleural Mesothelioma after Combination Chemotherapy with Carboplatin and Pemetrexed  Steven Chuan-Hao Kao,
Neuroendocrine Cancer of the Lung: A Diagnostic Puzzle
ALK Gene Rearrangements: A New Therapeutic Target in a Molecularly Defined Subset of Non-small Cell Lung Cancer  Benjamin Solomon, MBBS, PhD, Marileila.
Presentation transcript:

The 2015 World Health Organization Classification of Tumors of the Pleura: Advances since the 2004 Classification  Francoise Galateau-Salle, MD, Andrew Churg, MD, Victor Roggli, MD, William D. Travis, MD  Journal of Thoracic Oncology  Volume 11, Issue 2, Pages 142-154 (February 2016) DOI: 10.1016/j.jtho.2015.11.005 Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 1 Diffuse malignant mesothelioma, epithelioid type. (A) The pleomorphic pattern consists of large atypical and multinucleated tumor cells, some with prominent nucleoli. (B) The solid pattern, with sheets of epithelioid tumor cells. (C) The micropapillary pattern, with a nest of tumor cells growing in papillae lacking fibrovascular cores. (Reprinted from Travis et al.1, with permission from Dr. William D. Travis.) (D) Staining with calretinin shows positive nuclear and cytoplasmic reactivity. (Reprinted from Travis et al.1, with permission from Dr. Francoise Galateau-Salle.) Journal of Thoracic Oncology 2016 11, 142-154DOI: (10.1016/j.jtho.2015.11.005) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 2 Organizing pleuritis. (A) The pleural cavity is on the left, and the chest wall fat (not sampled) would appear on the right. The biopsy specimen reveals zonation—that is, it is more cellular adjacent to the pleural cavity and less cellular away from the pleural cavity. In addition, there is layering of mesothelial cells immediately adjacent to the pleural space; this is a sign of a benign process. This particular example shows fake fat located deep in the pleura near the junction with the chest wall; note the characteristic pattern of fat-like spaces parallel to the pleura surface (right). (B) Keratin staining of an area of fake fat from another case. Keratin-positive mesothelial cells run between the spaces (highlighted by arrows), suggesting the invasion of fat. However, all of the mesothelial cells are aligned parallel to the pleural surface and do not invade down (i.e., away from the pleural surface), the diagnostic finding that would be seen in desmoplastic mesothelioma. Journal of Thoracic Oncology 2016 11, 142-154DOI: (10.1016/j.jtho.2015.11.005) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 3 Diffuse malignant mesothelioma, sarcomatoid type with heterologous elements. (A) Malignant bone and cartilage represent osteosarcomatous and chrondrosarcomatous differentiation in this malignant mesothelioma. (B) Rhabdomyosarcomatous differentiation in this mesothelioma shows highly atypical tumor cell cytology with prominent epithelioid cytoplasm, suggesting rhabdomyoblasts. (C) Immunohistochemistry of the tumor in part B shows positive staining for myogenin, confirming rhabdomyosarcomatous differentiation. (B and C, Reprinted from Travis et al.1, with permission from Dr. William D. Travis.) Journal of Thoracic Oncology 2016 11, 142-154DOI: (10.1016/j.jtho.2015.11.005) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 4 Well differentiated papillary mesothelioma. (A) This tumor consists of exophytic surface growth on the pleural surface, consisting of papillary fronds with broad fibrovascular cores. No downward invasive growth was seen. (Reprinted from Travis et al.1, with permission from Dr. Francoise Galateau-Salle.) (B) These papillae have broad fibrovascular cores with a myxoid stroma. The surface of the papillae is lined by cuboidal mesothelial cells with bland cytology. Journal of Thoracic Oncology 2016 11, 142-154DOI: (10.1016/j.jtho.2015.11.005) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 5 Utility of p16 fluorescence in situ hybridization (FISH) to separate benign from malignant mesothelial proliferations. This patient was thought to have a mesothelioma, but the biopsy specimen was equivocal with vague stromal nodules (marked with an asterisk), suggestive of a desmoplastic mesothelioma. FISH (inset) reveals a complete loss of red p16 signals, indicating that the process is in fact malignant. Green signals represent centromere 9. Journal of Thoracic Oncology 2016 11, 142-154DOI: (10.1016/j.jtho.2015.11.005) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 6 BRCA1-associated protein 1 (BAP1) immunostaining in mesothelioma. These examples of mesotheliomas show the (A) retention and (B) loss of BAP1 from a tissue microarray. Arrows point out positive stromal cells and lymphocytes that serve as internal staining controls. Journal of Thoracic Oncology 2016 11, 142-154DOI: (10.1016/j.jtho.2015.11.005) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 7 Solitary fibrous tumor. (A) This neoplasm consists of spindle cells in a storiform pattern with a stroma showing prominent ropy collagen. (B) Immunohistochemistry for STAT6 shows diffuse strong nuclear staining. Journal of Thoracic Oncology 2016 11, 142-154DOI: (10.1016/j.jtho.2015.11.005) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 8 Epithelioid hemangioendothelioma. (A) The pleura is markedly thickened and infiltrated by a cellular neoplasm. There is extensive infiltration of parietal pleural fat. (B) The tumor has a hyaline stroma infiltrated by cytologically bland epithelioid cells with some intracytoplasmic lumens (center). (C) CD31 shows diffuse strong staining. (D and E) Fluorescence in situ hybridization analysis using custom BAC probes shows break-apart signals (arrows in CAMTA1 [D] and WWTR1 [E]). Red, centromeric; green, telomeric. (D and E, Courtesy of Dr. Cristina Antonescu.) Journal of Thoracic Oncology 2016 11, 142-154DOI: (10.1016/j.jtho.2015.11.005) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 9 Desmoid tumor. (A) This tumor consists of bland spindle cells with sharply tapered nuclei growing within a fibrous stroma. (B) Immunohistochemistry for β-catenin shows positive nuclear staining. Journal of Thoracic Oncology 2016 11, 142-154DOI: (10.1016/j.jtho.2015.11.005) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions