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

Title: A multidisciplinary approach for the differential diagnosis between multiple primary lung adenocarcinomas and intrapulmonary metastases
Authors: 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.
Contributors: 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.
Publisher Information: Elsevier GmbH; HACKERBRUCKE 6, 80335 MUNICH, GERMANY
Publication Year: 2021
Collection: Sapienza Università di Roma: CINECA IRIS
Subject Terms: intrapulmonary metastasi; metachronou; multiple primary lung cancer; NGS; synchronous
Description: 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.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/33647865; info:eu-repo/semantics/altIdentifier/wos/WOS:000636762000008; volume:220; numberofpages:9; journal:PATHOLOGY RESEARCH AND PRACTICE; http://hdl.handle.net/11573/1574925
DOI: 10.1016/j.prp.2021.153387
Availability: http://hdl.handle.net/11573/1574925; https://doi.org/10.1016/j.prp.2021.153387
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.E28EB456
Database: BASE