Invasive mucinous adenocarcinoma of the lung

Last revised by Dr Mohamed Saber on 28 Jul 2021

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. 

Terminology

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)".

Pathology

Location

Mucinous carcinomas are commonly multicentric, multilobar, and may show bilateral lung involvement 3,4. These patterns may indicate aerogenous spread 4.

Microscopic appearance

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.  

Genetics

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Cases and figures

  • Case 1
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  • Case 2: serial follow-up
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  • Case 3: invasive mucinous adenocarcinoma
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