Wang, C., Durra, H. Y., Huang, Y., & Manucha, V. (2014). Interobserver reproducibility study of the histological patterns of primary lung adenocarcinoma with emphasis on a more complex glandular pattern distinct from the typical acinar pattern. International Journal Of Surgical Pathology, 22(2), 149-155. doi:10.1177/1066896913519165
Interobserver Reproducibility Study of the Histological Patterns of Primary Lung Adenocarcinoma With Emphasis on a More Complex Glandular Pattern Distinct from the Typical Acinar Pattern.International journal of surgical pathology
AbstractThe newly proposed International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society (IASLC/ATS/ERS) classification of lung adenocarcinoma has emphasized the prognostic significance of histological subtyping. In this study, 2 surgical pathologists reevaluated 49 consecutive cases of invasive primary pulmonary adenocarcinomas; histological subtyping was performed according to the IASLC/ATS/ERS classification. The 2 reviewers agreed on the predominant pattern in 23 out of 32 independently reviewed cases (71.9%, k = 0.628, 95% confidence interval = 0.442-0.815). Postconsensus, a complex glandular pattern consisting of fused, closely packed glands and cribriform architecture was identified in 9 of 49 (18%) cases. This pattern has a strong association with lymphovascular invasion (78%; P = .0091), high mitotic activity (89%), and higher tumor stage (78%). Frequent association of complex glandular pattern with poor prognostic factors and its overlap with acinar pattern warrant a more detailed description of this pattern in the classification system and a large-scale study to evaluate its prognostic significance.