Micropapillary carcinoma of lung

Micropapillary architecture occurs in adenocarcinoma of the lung, breast, colon and ovary, and in transitional cell carcinoma of the urinary bladder. In lung, breast and bladder, a micropapillary component is associated with more aggressive behavior and metastases tend to have a micropapillary architecture. Micropapillary serous carcinoma of the ovary has a significantly worse prognosis than do typical serous borderline tumours2.

One study found a micropapillary component in 16 of 35 stage I lung adenocarcinomas, suggesting a more lax criterion and usual: even so there was an association with nodal micro-metastases4.

Histopathology

Micropapillary carcinomas are composed of papillary structures without a central vascular core; this distinguishes them form papillary adenocarcinomas. In the lung, a micropapillary component may be associated with any of the subtypes of adenocarcinoma

Immunohistochemistry

CK7+/CK20+

CK7+/CK20-

CK7-/CK20+

CK7-/CK20-

TTF-1

2/151

12/151

0/151

1/151

12/151

Prognosis

Microscopic metastases are common and clinical stage I carcinomas are often up-staged by pathological examination of lymph nodes. Once lymph node metastases occur, the prognosis is poor3.

References

1Amin, M. B., Tamboli, P., Merchant, S. H., Ordonez, N. G., Ro, J., Ayala, A. G., Ro, J. Y. Micropapillary component in lung adenocarcinoma: a distinctive histologic feature with possible prognostic significance. Am J Surg Pathol 2002;26:358-364.

2Staebler, A., Heselmeyer-Haddad, K., Bell, K., Riopel, M., Perlman, E., Ried, T., Kurman, R. J. Micropapillary serous carcinoma of the ovary has distinct patterns of chromosomal imbalances by comparative genomic hybridization compared with atypical proliferative serous tumors and serous carcinomas. Human Pathol 2002;33:47-59.

3Miyoshi, T., Y. Satoh, et al. (2003). "Early-stage lung adenocarcinomas with a micropapillary pattern, a distinct pathologic marker for a significantly poor prognosis." Am J Surg Pathol 27(1): 101-9.

4Roh, M. S., J. I. Lee, et al. (2004). "Relationship between micropapillary component and micrometastasis in the regional lymph nodes of patients with stage I lung adenocarcinoma." Histopathology 45(6): 580-6.

This page last revised 18.12.2004.

©SMUHT/PW Bishop