ADENOCARCINOMA OF THE LUNG FACT SHEET

Definition
Malignant epithelial tumor with glandular differentiation or mucin production (World
Health Organization)
Incidence
35% of primary lung cancers
Clinical Features
Association with cigarette smoking is less than other lung cancers
May be asymptomatic or associated with chest pain, cough, or constitutional
symptoms
Radiologic Features
Focal masses, nodular patterns, or pneumonic or diffuse forms
May present as pleural thickening or with a pleural effusion
ADENOCARCINOMAPATHOLOGIC FEATURES
Gross Findings
Nodule, mass or infi ltrative process, usually tan-white, with irregular or well
circumscribed borders
Predominantly peripheral
Rarely associated with large airways
Commonly associated with fibrosis or scar
Necrosis may be present
Microscopic Findings
Four major histologic sub-types : acinar, papillary, solid with mucin production,
bronchioloalveolar
Other rarer subtypes include fetal adenocarcinoma, mucinous (colloid) carcinoma,
mucinous cystadenocarcinoma, signet ring adenocarcinoma, clear cell adenocarcinoma
80% present as mixed type
Immunohistochemical Features
Most are positive for TTF-1, surfactant proteins, and cytokeratin 7
Most are negative for cytokeratin 20
Pathologic Differential Diagnosis
Malignant mesothelioma
Metastatic adenocarcinomas