Department of Pathology, Taipei Medical University Hospital, Taipei, Taiwan.
Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Histopathology. 2024 Jan;84(1):18-31. doi: 10.1111/his.15064. Epub 2023 Oct 22.
Invasive mucinous adenocarcinoma (IMA) is a relatively rare subtype of lung adenocarcinoma, composed of goblet and/or columnar tumour cells containing abundant intracytoplasmic mucin vacuoles. While a majority of IMAs are driven by KRAS mutations, recent studies have identified distinct genomic alterations, such as NRG1 and ERBB2 fusions. IMAs also more frequently present as a pneumonic-like pattern with multifocal and multilobar involvement, and comparative genomic profiling predominantly shows a clonal relationship, suggesting intrapulmonary metastases rather than synchronous primary tumours. Accordingly, these unique features require different therapeutic approaches when compared to nonmucinous adenocarcinomas in general. In this article, we review recent updates on the histopathological, clinical, and molecular features of IMAs, and also highlight some unresolved issues for future studies.
浸润性黏液性腺癌（IMA）是一种相对罕见的肺腺癌亚型，由含有丰富细胞内黏液空泡的杯状和/或柱状肿瘤细胞组成。虽然大多数 IMA 由 KRAS 突变驱动，但最近的研究已经确定了不同的基因组改变，如 NRG1 和 ERBB2 融合。IMA 也更常表现为多灶性和多叶性受累的肺炎样模式，比较基因组分析主要显示克隆关系，提示肺内转移而不是同步的原发性肿瘤。因此，与一般的非黏液性腺癌相比，这些独特的特征需要不同的治疗方法。本文综述了 IMA 的组织病理学、临床和分子特征的最新进展，并强调了未来研究中一些尚未解决的问题。
