Mucinous (“Colloid”) Carcinoma

Mucinous (“Colloid”) Carcinoma
Gross photograph of mucinous carcinoma shows a well-defined subpleural tumor with a mucoid consistency. No evidence of necrosis or hemorrhage is present.
Lung parenchyma is replaced by extensive areas of mucoid material that destroy alveolar walls. This presentation may mimic a benign mucinous cyst.
TERMINOLOGY
Synonyms
  • Mucinous cystadenoma, mucinous cystic tumor, multilocular cystic carcinoma, mucinous cystic tumor of borderline malignancy
Definitions
  • Epithelial neoplasm with extensive mucin production
CLINICAL ISSUES
Epidemiology
  • Incidence
    • Pure colloid carcinomas of the lung are rare
  • Age
    • Colloid carcinomas are more common in adult patients
  • Gender
    • No gender predilection
Presentation
  • Cough
  • Chest pain
  • Shortness of breath
  • Asymptomatic
Treatment
  • Surgical approaches
    • Lobectomy
Prognosis
  • Depends on staging at time of diagnosis
MACROSCOPIC FEATURES
General Features
  • Well-defined tumor mass
  • Mucoid consistency
  • Cystic changes may be present
Size
  • Varies from 1 to > 10 cm
MICROSCOPIC PATHOLOGY
Histologic Features
  • Extensive areas of mucin deposition
  • Alveolar wall lined with mucinous epithelium
  • Single cells or clusters of cells are seen floating in the mucin
Predominant Pattern/Injury Type
  • Mucinous
Predominant Cell/Compartment Type
  • Epithelial
DIFFERENTIAL DIAGNOSIS
Metastatic Mucinous Carcinoma of Extrathoracic Origin
  • Clinical history of or clinical evaluation for colonic, ovarian, breast, or urachal carcinoma will be important
  • Immunohistochemical studies important in determining primary site
Bronchioloalveolar Carcinoma (BAC), Mucinous Variant
  • In BAC, lepidic growth pattern is characteristic feature in which alveolar lining is substituted by mucinous type of epithelium
  • BAC commonly will diffusely involve the entire lung or extensive areas of it
  • Immunohistochemical features of BAC and colloid carcinoma may be similar
DIAGNOSTIC CHECKLIST
Clinically Relevant Pathologic Features
  • Gross appearance
Pathologic Interpretation Pearls
  • Extensive mucin
  • Alveolar wall lined with mucinous epithelium
GRADING
Colloid Carcinoma
  • Considered low-grade malignant neoplasm
  • Behavior determined by pathological staging at time of diagnosis
SELECTED REFERENCES
1. Bacha D et al: A pulmonary mucinous cystic tumour of borderline malignancy. Pathologica. 100(3):189-91, 2008
2. Maeda R et al: Primary pulmonary mucinous (colloid) adenocarcinoma. Gen Thorac Cardiovasc Surg. 56(4):195-8, 2008
3. Moran CA: Pulmonary adenocarcinoma: the expanding spectrum of histologic variants. Arch Pathol Lab Med. 130(7):958-62, 2006
4. Türüt H et al: Primary pulmonary mucinous adenocarcinoma in a 15-year-old boy. Eur J Cardiothorac Surg. 29(5):851-3, 2006
5. Brownlee NA et al: Mucinous (colloid) adenocarcinoma of the lung. Arch Pathol Lab Med. 129(1):121-2, 2005
6. Okimasa S et al: Mucinous (colloid) adenocarcinoma. Jpn J Thorac Cardiovasc Surg. 53(6):305-8, 2005
7. Jayaram G et al: Mucinous carcinoma (colloid carcinoma) of the lung diagnosed by fine needle aspiration cytology: a case report. Malays J Pathol. 25(1):63-8, 2003
8. Moran CA. Mucin-rich tumors of the lung. Adv Anat Pathol. 2(5):299-305, 1995
9. Moran CA et al: Mucinous (so-called colloid) carcinomas of lung. Mod Pathol. 5(6):634-8, 1992
10. Graeme-Cook F et al: Pulmonary mucinous cystic tumors of borderline malignancy. Hum Pathol. 22(2):185-90, 1991
Tables
Immunohistochemistry

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Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Mucinous (“Colloid”) Carcinoma

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