Purpose: The distinction between multiple primary lung cancers (MPLCs) and intrapulmonary metastases has a significant impact on tumor staging and therapeutic choices. Several criteria have been proposed to solve this diagnostic issue, but a definitive consensus is still missing. We tested the efficacy of a combined clinical, histopathological and molecular (“real world”) approach for the correct classification of multiple lung tumors in a selected cohort of patients. Methods: 24 multiple lung tumors with a diagnosis of adenocarcinoma from 10 patients were retrospectively reviewed. Radiological, pathological and clinical information, including follow-up, were integrated with molecular profiling via a routine multigene panel sequencing. Results: Comprehensive histologic assessment revealed readily distinguishable histologic patterns between multiple tumors suggesting unrelated lesions in 7 cases, in agreement with clinical, radiological and molecular data, thus leading to final diagnosis of MPLCs. In the remaining 3 cases, the differential diagnosis between MPLCs and intrapulmonary metastases was challenging, since the histologic features of the lesions were similar or identical. The final interpretation (2 MPLCs and 1 most likely intrapulmonary metastases) was reached thanks to the integration of all available data, and was confirmed by follow-up. Conclusions: A multidisciplinary approach including a routinely affordable multigene panel sequencing is a useful tool to discriminate MPLCs from intrapulmonary metastases in multiple lung nodules sharing the adenocarcinoma histotype.

A multidisciplinary approach for the differential diagnosis between multiple primary lung adenocarcinomas and intrapulmonary metastases / Belardinilli, F.; Pernazza, A.; Mahdavian, Y.; Cerbelli, B.; Bassi, M.; Gradilone, A.; Coppa, A.; Pignataro, M. G.; Anile, M.; Venuta, F.; Della Rocca, C.; Giannini, G.; D'Amati, G.. - In: PATHOLOGY RESEARCH AND PRACTICE. - ISSN 0344-0338. - 220:(2021). [10.1016/j.prp.2021.153387]

A multidisciplinary approach for the differential diagnosis between multiple primary lung adenocarcinomas and intrapulmonary metastases

Belardinilli F.
Co-primo
;
Pernazza A.
Co-primo
;
Cerbelli B.;Bassi M.;Gradilone A.;Coppa A.;Pignataro M. G.;Anile M.;Venuta F.;Della Rocca C.;Giannini G.
Penultimo
;
d'Amati G.
Ultimo
2021

Abstract

Purpose: The distinction between multiple primary lung cancers (MPLCs) and intrapulmonary metastases has a significant impact on tumor staging and therapeutic choices. Several criteria have been proposed to solve this diagnostic issue, but a definitive consensus is still missing. We tested the efficacy of a combined clinical, histopathological and molecular (“real world”) approach for the correct classification of multiple lung tumors in a selected cohort of patients. Methods: 24 multiple lung tumors with a diagnosis of adenocarcinoma from 10 patients were retrospectively reviewed. Radiological, pathological and clinical information, including follow-up, were integrated with molecular profiling via a routine multigene panel sequencing. Results: Comprehensive histologic assessment revealed readily distinguishable histologic patterns between multiple tumors suggesting unrelated lesions in 7 cases, in agreement with clinical, radiological and molecular data, thus leading to final diagnosis of MPLCs. In the remaining 3 cases, the differential diagnosis between MPLCs and intrapulmonary metastases was challenging, since the histologic features of the lesions were similar or identical. The final interpretation (2 MPLCs and 1 most likely intrapulmonary metastases) was reached thanks to the integration of all available data, and was confirmed by follow-up. Conclusions: A multidisciplinary approach including a routinely affordable multigene panel sequencing is a useful tool to discriminate MPLCs from intrapulmonary metastases in multiple lung nodules sharing the adenocarcinoma histotype.
2021
intrapulmonary metastasis; metachronous; multiple primary lung cancers; NGS; synchronous
01 Pubblicazione su rivista::01a Articolo in rivista
A multidisciplinary approach for the differential diagnosis between multiple primary lung adenocarcinomas and intrapulmonary metastases / Belardinilli, F.; Pernazza, A.; Mahdavian, Y.; Cerbelli, B.; Bassi, M.; Gradilone, A.; Coppa, A.; Pignataro, M. G.; Anile, M.; Venuta, F.; Della Rocca, C.; Giannini, G.; D'Amati, G.. - In: PATHOLOGY RESEARCH AND PRACTICE. - ISSN 0344-0338. - 220:(2021). [10.1016/j.prp.2021.153387]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1574925
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