Invasive mucinous adenocarcinoma of the lung
Citation, DOI & article data
Invasive mucinous adenocarcinoma of the lung is a subtype of invasive adenocarcinoma of the lung formerly known as mucinous bronchoalveolar carcinoma (BAC). They are more likely to be multicentric and tend to have a worse prognosis than non-mucinous types.
In 2011, the International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS), and European Respiratory Society (ERS) 4 introduced a new classification and terminology for adenocarcinoma of the lung. The term bronchoalveolar carcinoma (BAC) has fallen out of favor and "invasive mucinous adenocarcinoma of the lung" is the term currently used for the tumors previously known as "mucinous bronchoalveolar carcinoma (BAC)".
Mucinous carcinomas are commonly multicentric, multilobar, and may show bilateral lung involvement 3,4. These patterns may indicate aerogenous spread 4.
Mucinous carcinomas originate from columnar mucus-containing cells (cf. non-mucinous tumors which arise from club cells (i.e. bronchiolar exocrine cells, formerly known as Clara cells) or type 2 pneumocytes, showing a goblet or columnar cell morphology with abundant intracytoplasmic mucin 3,4. The alveoli are usually filled with mucin 4.
Although also consisting of a mixture of histologic patterns, e.g. lepidic, acinar, papillary, micropapillary, and solid growth, as we observe in the nonmucinous invasive tumors, there is no recommendation to subcategorise the invasive mucinous adenocarcinomas, as the clinical relevance of doing so is still uncertain 4.
- 1. Austin JH, Garg K, Aberle D et-al. Radiologic implications of the 2011 classification of adenocarcinoma of the lung. Radiology. 2013;266 (1): 62-71. Radiology (full text) - doi:10.1148/radiol.12120240 - Pubmed citation
- 2. Kadota K, Yeh YC, D'Angelo SP et-al. Associations between mutations and histologic patterns of mucin in lung adenocarcinoma: invasive mucinous pattern and extracellular mucin are associated with KRAS mutation. Am. J. Surg. Pathol. 2014;38 (8): 1118-27. doi:10.1097/PAS.0000000000000246 - Pubmed citation
- 3. Lee KS, Kim Y, Han J et-al. Bronchioloalveolar carcinoma: clinical, histopathologic, and radiologic findings. Radiographics. 1997;17 (6): 1345-57. doi:10.1148/radiographics.17.6.9397450 - Pubmed citation
- 4. Travis WD, Brambilla E, Noguchi M et-al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6 (2): 244-85. doi:10.1097/JTO.0b013e318206a221 - Pubmed citation
- 5. Tang ER, Schreiner AM, Pua BB. Advances in lung adenocarcinoma classification: a summary of the new international multidisciplinary classification system (IASLC/ATS/ERS). (2014) Journal of thoracic disease. 6 (Suppl 5): S489-501. doi:10.3978/j.issn.2072-1439.2014.09.12 - Pubmed
- 6. Shim HS, Kenudson M, Zheng Z, Liebers M, Cha YJ, Hoang Ho Q, Onozato M, Phi Le L, Heist RS, Iafrate AJ. Unique Genetic and Survival Characteristics of Invasive Mucinous Adenocarcinoma of the Lung. (2015) Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 10 (8): 1156-62. doi:10.1097/JTO.0000000000000579 - Pubmed