Pneumonic-type lung adenocarcinoma with different ranges exhibiting different clinical, imaging, and pathological characteristics

Insights into Imaging

Xian Li¹  Jun-wei Gong²  Xing-tao Huang²  Ji-wen Huo²  Tian-you Luo²  Qi Li² 

[1] Department of Pathology, Chongqing Medical University, No.1 Youyi Road, Yuzhong District, 400016, Chongqing, China;Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, 400016, Yu zhong District, Chongqing, China;

关键词: Pneumonic-type lung adenocarcinoma;    Tomography (X-ray computed);    Epidermal growth factor receptor;   

DOI  :  10.1186/s13244-021-01114-2

来源: Springer

【 摘 要 】

BackgroundPneumonic-type lung adenocarcinoma (PLADC) with different ranges might exhibit different imaging and clinicopathological features. This study divided PLADC into localized PLADC (L-PLADC) and diffuse PLADC (D-PLADC) based on imaging and aimed to clarify the differences in clinical, imaging, and pathologic characteristics between the two new subtypes.ResultsThe data of 131 patients with L-PLADC and 117 patients with D-PLADC who were pathologically confirmed and underwent chest computed tomography (CT) at our institute from December 2014 to December 2020 were retrospectively collected. Patients with L-PLADC were predominantly female, non-smokers, and without respiratory symptoms and elevated white blood cell count and C-reactive protein level, whereas those with D-PLADC were predominantly male, smokers, and had respiratory symptoms and elevated white blood cell count and C-reactive protein level (all p < 0.05). Pleural retraction was more common in L-PLADC, whereas interlobular fissure bulging, hypodense sign, air space, CT angiogram sign, coexisting nodules, pleural effusion, and lymphadenopathy were more frequent in D-PLADC (all p < 0.001). Among the 129 patients with surgically resected PLADC, the most common histological subtype of L-PLADC was acinar-predominant growth pattern (76.7%, 79/103), whereas that of D-PLADC was invasive mucinous adenocarcinoma (80.8%, 21/26). Among the 136 patients with EGFR mutation status, L-PLADC had a significantly higher EGFR mutation rate than D-PLADC (p < 0.001).ConclusionsL-PLADC and D-PLADC have different clinical, imaging, and pathological characteristics. This new imaging-based classification may help improve our understanding of PLADC and develop personalized treatment plans, with concomitant implications for patient outcomes.

【 授权许可】

CC BY