by
THOMAS V. COLBY, M.D.
Laboratory of Medicine and Pathology
Mayo Clinic Scottsdale
Scottsdale, Arizona 85259
MICHAEL N. KOSS, M.D.
Co-Chairman
Department of Pulmonary
and Mediastinal Pathology
Armed Forces Institute of Pathology
Washington, D.C. 20306-6000
and
Department of Pathology
University of Southern California
Los Angeles, California 90033
WILLIAM D. TRAVIS, M.D.
Co-Chairman
Department of Pulmonary
and Mediastinal Pathology
Armed Forces Institute of Pathology
Washington, D.C. 20306-6000
1 Introduction and Classification
1.1 WHO Histologic Typing of Lung Tumors
2 Embryology, Anatomy, and Congenital, Developmental, and Related Lesions
2.1 Embryology
2.2 Anatomy and Histology
2.3 Congenital Anomalies and Related Lesions
2.3.1 Bronchial Atresia (Regional or Segmental Pulmonary
Overinflation)
2.3.2 Pulmonary Sequestration (Intralobar Sequestration, Extralobar
Sequestration)
2.3.3 Congenital Bronchopulmonary Foregut Malformations
2.3.4 Bronchogenic Cysts (Bronchial Cysts)
2.3.5 Congenital Cystic Adenomatoid Malformation
2.3.6 Infantile Lobar Emphysema/Polyalveolar Lobe
2.3.7 Pulmonary Interstitial Emphysema
2.3.8 Diffuse Pulmonary Lymphangiectasia
2.3.9 Ectopic Tissues in the Lung
3 Specimen Handling and Special Techniques
3.1 Routine Handling of Lung Specimens
3.1.1 The Surgical Pathology Report
3.2 Special Techniques
3.2.1 Immunohistochemistry
3.2.2 Flow Cytometry
3.2.3 Molecular Biology
4 Papillary Tumors of the Bronchial Tree
4.1 Squamous Papilloma and Papillomatosis
4.2 Other Bronchial Papillomas
4.2.1 Columnar Papillomas
4.2.2 Inverted Papillomas or Polyps
4.2.3 Transitional Cell Papillomas
4.2.4 Fibroepithelial Polyps
5 Miscellaneous Benign Epithelial Tumors
5.1 Papillary Adenoma of Type 2 Cells
5.2 Alveolar Adenoma
5.3 Mucinous Cystadenoma and Pulmonary Mucinous Tumors of Borderline
Malignancy
5.3.1 Mucinous Cystadenoma
5.3.2 Mucinous Cystic Tumor of Borderline Malignancy
6 Tumors of Salivary Gland Type
6.1 Mucoepidermoid Carcinoma of the Bronchus
6.2 Adenoid Cystic Carcinoma
6.3 Mucous Gland Adenoma
6.4 Pleomorphic Adenoma
6.5 Acinic Cell Carcinoma
6.6 Other Rare Salivary Gland Tumors
6.6.1 Carcinoma ex Pleomorphic Adenoma (Malignant Mixed Tumor)
6.6.2 Pulmonary Oncocytoma
6.6.3 Myoepithelioma
6.6.4 Adenosquamous Carcinoma with Amyloid-like Stroma
7 Carcinoma of the Lung: Overview, Incidence, Etiology, and Screening
7.1 Overview
7.2 Incidence
7.3 Etiology and Pathogenesis
7.4 Screening for Carcinoma of the Lung
8 Carcinoma of the Lung: Clinical and Radiographic Aspects, Spread,
Staging, Management, and Prognosis
8.1 Demographics
8.2 Signs and Symptoms
8.3 Radiographic Features
8.4 Patterns of Spread
8.5 Staging, Management, and Prognosis
9 Morphologic Diagnosis and Heterogeneity of Carcinoma of the Lung
9.1 Diagnosis
9.2 Histologic Heterogeneity
10 In Situ and Early Invasive (Occult) Squamous Cell Carcinoma
11 Squamous Cell Carcinoma and Variants
12 Adenocarcinoma of the Lung (Excluding Bronchioloalveolar Carcinoma)
13 Bronchioloalveolar Carcinoma
14 Small Cell Carcinoma and Large Cell Neuroendocrine Carcinoma
14.1 Small Cell Carcinoma
14.2 Large Cell Neuroendocrine Carcinoma
15 Large Cell Carcinoma
16 Adenosquamous Carcinoma, Carcinomas Associated with Cysts, and Paget
Disease of the Bronchus
16.1 Adenosquamous Carcinoma
16.2 Carcinomas Associated with Lung Cysts
16.3 Pagetoid Spread of Adenocarcinoma in the Bronchus
17 Carcinoid and Other Neuroendocrine Tumors
17.1 Unifying Concept of Pulmonary Neuroendocrine Tumors
17.1.1 Neuroendocrine Cells
17.1.2 Classification
17.1.3 Neuroendocrine Body
17.2 Carcinoid Tumorlet
17.3 Typical and Atypical Carcinoid Tumors
17.4 Unusual Lung Tumors with Neuroendocrine Differentiation
17.4.1 Paraganglioma
17.4.2 Primitive Neuroectodermal Tumor (Malignant Small Round Cell
Tumor of the Thoracopulmonary Region)
17.4.3 Neuroendocrine Carcinoma with Rhabdoid Phenotype
17.4.4 Amphicrine Neoplasms
17.4.5 Neuroendocrine Carcinoma with Anemone Features
17.4.6 Pulmonary Blastoma with Neuroendocrine Differentiation
18 Hamartoma
19 Fibrous and Fibrohistiocytic Tumors and Tumor-Like Conditions
19.1 Inflammatory Pseudotumor (Plasma Cell Granuloma-Histiocytoma
Complex)
19.2 Intrapulmonary Localized Fibrous Tumor
19.3 Malignant Fibrous Histiocytoma
19.4 Miscellaneous Fibrous and Fibrohistiocytic Tumors
19.4.1 Fibrosarcomas
19.4.2 Mesenchymal Cystic Hamartoma
19.4.3 Cystic Fibrohistiocytic Tumor
20 Miscellaneous Mesenchymal Tumors
20.1 Smooth Muscle Tumors
20.1.1 Leiomyoma and Leiomyosarcoma
20.1.2 Lymphangioleiomyomatosis
20.1.3 Glomus Tumors
20.2 Skeletal Muscle Tumors
20.2.1 Rhabdomyoma
20.2.2 Rhabdomyosarcoma
20.3 Vascular Tumors and Related Conditions
20.3.1 Vascular Malformations
20.3.2 Hemangioma/Hemangiomatosis
20.3.3 Lymphatic Lesions
20.3.4 Epithelioid Hemangioendothelioma
20.3.5 Kaposi Sarcoma
20.3.6 Pulmonary Angiosarcoma
20.3.7 Pulmonary Artery and Vein Sarcomas
20.3.8 Hemangiopericytoma
20.4 Neurogenic Tumors
20.4.1 Neurilemmoma and Neurofibroma
20.4.2 Neuroma and Ganglioneuroma
20.4.3 Malignant Nerve Sheath Tumors
20.4.4 Malignant Psammomatous Melanotic Schwannoma
20.4.5 Neuroblastoma and Ganglioneuroblastoma
20.4.6 Meningioma
20.5 Cartilaginous Tumors of the Lung
20.5.1 Chondroma
20.5.2 Chondroblastoma
20.5.3 Chondrosarcoma
20.6 Osteogenic Tumors
20.6.1 Metaplastic Bone
20.6.2 Osteosarcoma
20.7 Fatty Tumors
20.7.1 Lipomas
20.7.2 Liposarcomas
20.8 Aveolar Soft Part Sarcoma
21 Mixed Epithelial and Mesenchymal Tumors
21.1 Pulmonary Blastoma
21.1.1 Well-Differentiated Fetal Adenocarcinoma (Pulmonary
Endodermal Tumor)
21.1.2 Biphasic Pulmonary Blastoma
21.1.3 Cystic and Pleuropulmonary Blastomas of Childhood
21.2 Carcinosarcomas of the Lung
22 Lymphoreticular Disorders
22.1 Histologic Diagnosis of Lymphoreticular Infiltrates in the Lung
22.2 Lymphatics and Lymphoid Tissue of the Lung
22.3 Benign/Hyperplastic Disorders
22.3.1 Pseudolymphoma (Nodular Lymphoid Hyperplasia)
22.3.2 Lymphocytic Interstitial Pneumonia and Diffuse Lymphoid
Hyperplasia
22.3.3 Giant Lymph Node Hyperplasia (Castleman Disease)
22.3.4 Angioimmunoblastic Lymphadenopathy
22.4 Lymphomas Presenting in Lung
22.4.1 Small Lymphocytic and Lymphoplasmacytoid Lymphomas (Including
Low-Grade Lymphomas of BALT)
22.4.2 Angiocentric Immunproliferative Lesions/Angiocentric
Lymphomas (Lymphomatoid Granulomatosis/Polymorphic
Reticulosis)
22.4.3 Large Cell Lymphoma of Lung
22.4.4 Intravascular Lymphomatosis (Angiotropic Lymphoma)
22.4.5 Other Non-Hodgkin Lymphomas of the Lung
22.4.6 Primary Pulmonary Hodgkin Disease
22.4.7 Plasmacytoma
22.4.8 Mast Cell Tumor
22.5 Systemic Lymphoproliferative Disorders Secondarily Involving the
Lung
22.5.1 Hodgkin Disease and Non-Hodgkin Lymphoma
22.5.2 Cutaneous T-Cell Lymphomas (Mycosis Fungoides and Sézary
Syndrome)
22.5.3 Malignant Histiocytosis
22.5.4 Multiple Myeloma
22.5.5 Systemic Light Chain Disease
22.5.6 Waldenström Macroglobulinemia
22.6 Post-Transplant Lymphoproliferative Disorders and Related
Conditions
22.7 Leukemic Infiltrates Involving the Lung
22.7.1 Myelofibrosis
22.8 Pleural Involvement in Lymphoreticular Disorders
22.9 Pulmonary Histiocytosis X
23 Miscellaneous Tumors and Tumors of Uncertain Histogenesis
23.1 Sclerosing Hemangioma of the Lung
23.2 Clear Cell Tumor
23.3 Minute Pulmonary Meningothelial-Like Nodules ("Minute Pulmonary
Chemodectomas")
23.4 Granular Cell Tumor
23.5 Thymoma
23.6 Malignant Melanoma
23.7 Germ Cell Tumors
23.7.1 Teratoma
23.7.2 Choriocarcinoma
23.8 Ependymoma
24 Tumor-Like Conditions
24.1 Nodular Pulmonary Amyloidosis
24.2 Pulmonary Hyalinizing Granuloma
24.3 Pulmonary Malakoplakia
24.4 Rounded Atelectasis
24.5 Focal Organizing Pneumonia
25 Tumors Metastatic to the Lung
25.1 Patterns of Metastasis
25.1.1 Multiple Nodules
25.1.2 Lymphangitic Metastasis
25.1.3 Endobronchial Metastasis
25.1.4 Metastatic Tumor Embolization
25.1.5 The Solitary Pulmonary Metastasis
25.1.6 Pleural Metastases
25.2 Distinctive Histologic Growth Patterns
25.2.1 Lepidic Growth Pattern
25.2.2 Interstitial Spread
25.2.3 Cavitation
25.3 Special Techniques and Their Application in the Diagnosis of
Pulmonary Metastases
25.3.1 Immunohistochemistry
25.3.2 Electron Microscopy
25.3.3 Oncogenes
26 Index