Moran Cesar A
From the Department of Pathology, MD Anderson Cancer Center, Houston, TX.
Arch Pathol Lab Med. 2025 Apr 1;149(4):e87-e92. doi: 10.5858/arpa.2023-0414-RA.
CONTEXT.—: The great majority of primary pulmonary neoplasms are represented by non-small cell carcinomas-adenocarcinoma and squamous cell carcinoma. In addition, there is another group of neoplasms such as those of neuroendocrine origin that also represent a meaningful subset of primary lung neoplasms. Basically, any other tumor that is not in these groups of tumors may represent an unusual lung neoplasm.
OBJECTIVE.—: To highlight more recently described unusual tumoral entities that may represent a challenge in diagnosis and that require awareness of their existence.
DATA SOURCES.—: This is a review of 3 different entities: bronchiolar adenoma, adenofibroma, and hemangioblastoma-like clear cell stromal tumor. These tumoral conditions are rare, and a review of the literature is presented. The most relevant morphologic, immunohistochemical, and molecular aspects of bronchiolar adenoma, adenofibroma, and hemangioblastoma-like clear cell stromal tumor are presented. The difficulty of arriving at an unequivocal diagnosis in small biopsies is highlighted.
CONCLUSIONS.—: The 3 entities represent uncommon tumors occurring primarily in the lung and a diagnostic challenge not only in biopsy specimens but also often in surgically resected specimens. The use of immunohistochemical stains and in some cases of molecular diagnostics is of aid in arriving at final interpretation.
绝大多数原发性肺肿瘤由非小细胞癌——腺癌和鳞状细胞癌构成。此外，还有另一组肿瘤，如神经内分泌起源的肿瘤，它们也是原发性肺肿瘤中有意义的一个子集。基本上，不在这些肿瘤组中的任何其他肿瘤都可能代表一种不常见的肺肿瘤。
强调最近描述的不常见肿瘤实体，这些实体在诊断中可能构成挑战，需要意识到它们的存在。
这是对3种不同实体的综述：细支气管腺瘤、腺纤维瘤和成血管细胞瘤样透明细胞间质瘤。这些肿瘤情况罕见，并对文献进行了综述。介绍了细支气管腺瘤、腺纤维瘤和成血管细胞瘤样透明细胞间质瘤最相关的形态学、免疫组化和分子方面。强调了在小活检标本中做出明确诊断的困难。
这3种实体代表主要发生在肺部的罕见肿瘤，不仅在活检标本中，而且在手术切除标本中通常也是诊断挑战。免疫组化染色的应用以及在某些情况下分子诊断有助于做出最终诊断。
