Mucinous (“Colloid”) Carcinoma
Key Facts
Terminology
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Mucinous cystadenoma, mucinous cystic tumor, multilocular cystic carcinoma, mucinous cystic tumor of borderline malignancy
Macroscopic Features
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Well-defined tumor mass with mucoid consistency, solid &/or cystic
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Varies from 1 to > 10 cm
Microscopic Pathology
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Extensive areas of mucinous deposition
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Alveolar wall lined with mucinous epithelium
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Single cells or clusters of cells embedded in mucin
Ancillary Tests
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TTF-1 nuclear positivity (may be negative in some cases)
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CK7 cytoplasmic positivity
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CK20 negative (may be positive in some cases)
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CDX2 negative (may be positive in some cases)
Top Differential Diagnoses
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Metastatic mucinous carcinoma of extrathoracic origin
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Clinical history of or clinical evaluation for colonic, ovarian, breast, or urachal carcinoma will be important
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Immunohistochemical studies important in determining primary site
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Diagnostic Checklist
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Extensive mucin
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Alveolar wall lined with mucinous epithelium
TERMINOLOGY
Synonyms
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Mucinous cystadenoma, mucinous cystic tumor, multilocular cystic carcinoma, mucinous cystic tumor of borderline malignancy
Definitions
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Epithelial neoplasm with extensive mucin production
CLINICAL ISSUES
Epidemiology
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Incidence
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Pure colloid carcinomas of the lung are rare
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Age
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Colloid carcinomas are more common in adult patients
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Gender
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No gender predilection
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Presentation
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Cough
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Chest pain
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Shortness of breath
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Asymptomatic
Treatment
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Surgical approaches
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Lobectomy
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Prognosis
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Depends on staging at time of diagnosis
MACROSCOPIC FEATURES
General Features
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Well-defined tumor mass
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Mucoid consistency
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Cystic changes may be present
Size
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Varies from 1 to > 10 cm
MICROSCOPIC PATHOLOGY
Histologic Features
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Extensive areas of mucin deposition
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Alveolar wall lined with mucinous epithelium
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Single cells or clusters of cells are seen floating in the mucin
Predominant Pattern/Injury Type
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Mucinous
Predominant Cell/Compartment Type
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Epithelial
DIFFERENTIAL DIAGNOSIS
Metastatic Mucinous Carcinoma of Extrathoracic Origin
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Clinical history of or clinical evaluation for colonic, ovarian, breast, or urachal carcinoma will be important
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Immunohistochemical studies important in determining primary site
Bronchioloalveolar Carcinoma (BAC), Mucinous Variant
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In BAC, lepidic growth pattern is characteristic feature in which alveolar lining is substituted by mucinous type of epithelium
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BAC commonly will diffusely involve the entire lung or extensive areas of it
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Immunohistochemical features of BAC and colloid carcinoma may be similar
DIAGNOSTIC CHECKLIST
Clinically Relevant Pathologic Features
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Gross appearance
Pathologic Interpretation Pearls
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Extensive mucin
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Alveolar wall lined with mucinous epithelium
GRADING
Colloid Carcinoma
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Considered low-grade malignant neoplasm
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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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