Welcome to the March 2014 edition of Pulmonary Pathology Reviews, a monthly journal club intended to keep you up-to-date when it comes to peer reviewed papers of interest to those engaged in the practice of pulmonary pathology. This month comes to us courtesy of Joanne Yi at Mayo Clinic Minnesota where spring has finally sprung complete with thunderstorms and a predicted high of 62 degrees Fahrenheit! Check out her OVERVIEW below followed by an ARTICLE INDEX listing the papers she culled from the February 2014 print literature complete with links to PubMed abstracts (and full text if your institution allows it). Click here for her summary document, a PDF file intended as a Readers Digest version of those things likely to be of value or interest. If you want to hear how it all went down in the course of our monthly teleconference, click here to download a MP3 audiofile (be patient - may take awhile depending on your bandwidth).
I found 22 articles from our target journals that appear to be relevant for us to review. There seem to be a few more interesting articles on non-neoplastic side than it has been recently, especially on topics related to pulmonary hypertension and transplantation pathology. I dropped some articles on pulmonary hypertension that were too clinical and treatment oriented. A few review articles were noteworthy as well. I chose 4 articles for discussion to encompass the topics on lung adenocarcinomas, small cell lung cancers, and thymic epithelial neoplasms along with a new proposal for a new classification system for chronic lung allograft dysfunction.
Moreira et al from the Memorial Sloan-Kettering Cancer Center published a sort of addendum paper to their previous paper on a grading of lung adenocarcinomas. They assessed the prognostic importance of cribriform and fused glands in the grading schema and concluded that they are patterns of high-grade pulmonary adenocarcinoma
Schultheis et al studied amplifications of FGFR1 gene in small cell lung cancers and correlated with clinical data in a large cohort. Given the promising targeted therapy in several clinical trials using FGFR1 inhibitors in squamous cell lung cancers, this type of study might prove useful for future application of targeted therapies in small cell lung cancer field.
Mokhtar et al evaluated methylation and expression profiles of MGMT gene in thymomas and thymic carcinomas. Thymic tumors are another area that has been somewhat lagged behind in molecular profiling and approach for potential targeted therapy. MGMT methylation might play a role in development of thymic carcinoma and could be potential target for designer drug to treat some advanced cases.
Verleden et al proposed a new paradigm of classifying chronic lung allograft dysfunction. They introduced a new term CLAD (chronic lung allograft dysfunction) that encompasses classic bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). They also raised contentious issues that BOS might be due to broader spectrum of etiologies, not just due to chronic rejection mediated by alloimmune reaction.
Among the articles of notation, a study on the site and nature of airway obstruction after lung transplantation indicated that it will be very difficult to detect obliterative bronchiolitis in transbronchial biopsy, given the common involvement of conductive airways that are usually not very represented in such biopsies. A genetic study indicated that a subset of PCH might be a neoplastic condition after all. There are a few other interesting papers on neoplastic and non-neoplastic lung diseases that I encountered. Of note, the list of TTF1 and/or napsin positive extra pulmonary adenocarcinomas is growing and we all have to be aware of those pitfalls.
Articles for discussion
Moreira, AL et al. Cribriform and fused glands are patterns of high-grade pulmonary adenocarcinoma. Human Path 2014;45:213-220
Schultheis AM et al. Fibroblast growth factor receptor 1 (FGFR1) amplificatin is a potential therapeutic target in small-cell lung cancer. Mod Pathol 2014;27:214-221
Mokhtar, M et al. Methylation and expression profiles of MGMT gene in thymic epithelial tumors. Lung Cancer 2014;83:279-287
Verleden, GM et al. A new classification system for chronic lung allograft dysfunction. J Heart Lung Transplant 2014;33:127-133
Articles for notation – Neoplastic
Maus, MKH et al. KRAS mutations in non-small-cell lung cancer and colorectal cancer: Implications for EGFR-targeted therapies. Lung Cancer 2014;83:163-167
Krasinskas, AM et al. KRAS mutational analysis and immunohistochemical studies can help distinguish pancreatic metastases from primary lung adenocarcinomas. Mod Pathol 2014;27:262-270
Mescam-Mancini, L et al. On the relevance of a testing algorithm for the detection of ROS1-rearranged lung adenocarcinomas. Lung Cancer 2014;83:168-173
Toffart, AC et al. Immunohistochemistry evaluation of biomarker expression in non-small cell lung cancer (Pharmacogenoscan study). Lung Cancer 2014;83:182-188
Sun, JM et al. Clinical characteristics associated with ALK rearrangements in never-smokers with pulmonary adenocarcinoma. Lung Cancer 2014;83:259-264
Figueiredo-Pontes, LL. Identification and characterization of ALK kinase splicing isoforms in non-small-cell lung cancer. J Thorac Oncol 2014;9:248-253.
Surrey, et al. TTF-1 and Napsin -A are expressed in a subset of cholagiocarcinomas arisng from the gallbladder and hapatic ducts. Continued caveats for utilization of immunohitochemistry panels. Am J Surg Pathol 2014;38:224-227
Fadare et al. Frequent expression of napsin A in clear cell carcinoma of the endometrium. potential diagnostic utility. Am J Surg Pathol 2014;38:189-196
Articles for notation – Non-neoplastic
Verleden et al. The site and nature of airway obstruction after lung transplantation. Am J Respir Crit Care Med 2014;189:292-300
Dweik, RA et al. An official American Thoracic Society statement: Pulmonary hypertension phenotypes. Am J Respir Crit Care Med 2014;189:345-355
Assayag, D et al. Rheumatoid arthritis-associated interstitial lung disease: Radiologic identification of usual interstitial pneumonia pattern. Radiology; 270:583-588
Shi, L et al. Risk of interstitial lung disease with gefitinib and erlotinib in advanced non-small cell lung cancer: A systematic review and meta-analysis of clinical trials. Lung Cancer 2014;83:231-239
Best, DH et al. EIF2AK4 mutations in pulmonary capillary hemangiomatosis. Original research: Pulmonary vascular disease. Chest 2014;145: 231-6
Langleben, D. Pulmonary capillary hemangiomatosis. Chest 2014;145:197-199
Reviews and letter to the editor
Husain, AN. Mesothelial proliferations: useful marker is not the same as a diagnostic one. Am J Clin Pathol 2014;141:152-153
Allen, TC et al. Interleukin 8 and acute lung injury. Arch Pathol Lab Med 2014;138:266-269
Schneider, F et al. Approach to lung biopsies from patients with pneumothorax. Arch Pathol Lab Med Feb 2014;138:257-265
Epaud, R et al. Combined pulmonary fibrosis and emphysema syndrome associated with ABCA3 mutations. Eur Respir J 2014;43:638-641