Lin Dong-Liang, Xing Xiao-Ming, Ran Wen-Wen, Zhao Han, Li Guang-Qi, Xu Jin, Wang Yan, Shao Shi-Hong, Wang Ji-Gang
Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Histopathology. 2020 Jun;76(7):997-1004. doi: 10.1111/his.14098. Epub 2020 May 11.
Pulmonary peripheral glandular papilloma (GP) and mixed squamous cell and glandular papilloma (MP) have very similar histological features to pulmonary ciliated muconodular papillary tumour (CMPT)/bronchiolar adenoma (BA). The underlying genetic relationships between GP/MP and CMPT/BA have rarely been characterised. We aimed to reveal the relationship between them.
We performed a clinicopathological review and next-generation sequencing (NGS) study of two GPs and five MPs. Histologically, GPs/MPs showed similar cellular and architectural features to CMPTs/BAs, such as bilayered epithelium, bronchiole-associated lesions and skipping (discontinuous) growth pattern. One MP showed partial and inconspicuous endobronchiolar growth and more glandular structures, which was very similar to the appearance of CMPT/BA. BRAF V600E mutation was detected in four papillomas (57.1%, one GP and three MPs).
Overlapping morphological features and comparable mutation profiles support that peripheral GPs/MPs and CMPTs/BAs are on the same disease spectrum. We propose expanding the concept of CMPT/BA and including GP and MP in the CMPT/BA family.
肺外周腺性乳头状瘤（GP）和混合性鳞状细胞及腺性乳头状瘤（MP）的组织学特征与肺纤毛黏液结节性乳头状肿瘤（CMPT）/细支气管腺瘤（BA）非常相似。GP/MP与CMPT/BA之间潜在的遗传关系鲜有报道。我们旨在揭示它们之间的关系。
我们对2例GP和5例MP进行了临床病理回顾及二代测序（NGS）研究。组织学上，GP/MP表现出与CMPT/BA相似的细胞和结构特征，如双层上皮、细支气管相关病变及跳跃性（间断性）生长模式。1例MP表现出部分且不明显的支气管内生长以及更多的腺性结构，这与CMPT/BA的表现非常相似。在4例乳头状瘤（57.1%，1例GP和3例MP）中检测到BRAF V600E突变。
重叠的形态学特征和可比的突变谱支持外周GP/MP和CMPT/BA属于同一疾病谱。我们建议扩大CMPT/BA的概念，将GP和MP纳入CMPT/BA家族。
