Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing

S. Lantuejoul, T. V. Colby, G. R. Ferretti, P. Y. Brichon, C. Brambilla, E. Brambilla

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Pulmonary adenocarcinoma of the lung and its variants are well-defined entities, since the recent WHO classification of lung tumours. However, scant descriptions have been allocated to associated stromal changes, such as prominent inflammation and fibrosis, which can overshadow a tumoral proliferation and masquerade as a benign reactive process and this has not been recognised as histopathological variant. The case of a 72-yr-old farmer who presented a multifocal well-differentiated adenocarcinoma that mimicked honeycomb lung with bronchiolectasis radiologically, on computed tomography scan and histologically at open lung biopsy, is reported. Histological pitfalls in the biopsy were represented by mild atypical cuboidal or columnar epithelial cells lining bronchiolar structures resembling florid bronchiolar metaplasia in a background of extensive fibrosis and inflammation, features that mimicked inflammatory honeycombing. However, histological analysis of the surgical resection of the main lesion, performed because of a clinical alteration of the patient, confirmed the diagnosis of multifocal adenocarcinoma of mixed subtype. A monomorphic proliferation of clear cells, lack of associated ciliated or squamous cells and presence of significant cytologic atypia gave a diagnosis of malignancy. This case illustrates how inflammatory and fibrotic changes may conceal a correct diagnosis of carcinoma and emphasises the importance of adequate sampling in such cases.

Original languageEnglish (US)
Pages (from-to)502-505
Number of pages4
JournalEuropean Respiratory Journal
Volume24
Issue number3
DOIs
StatePublished - Sep 2004

Fingerprint

Lung Diseases
Lung
Adenocarcinoma
Fibrosis
Epithelial Cells
Inflammation
Biopsy
Metaplasia
Neoplasms
Tomography
Cell Proliferation
Carcinoma
Adenocarcinoma of lung
Farmers

Keywords

  • Honeycombing
  • Inflammatory stroma
  • Lung cancer

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Lantuejoul, S., Colby, T. V., Ferretti, G. R., Brichon, P. Y., Brambilla, C., & Brambilla, E. (2004). Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing. European Respiratory Journal, 24(3), 502-505. https://doi.org/10.1183/09031936.04.00124703

Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing. / Lantuejoul, S.; Colby, T. V.; Ferretti, G. R.; Brichon, P. Y.; Brambilla, C.; Brambilla, E.

In: European Respiratory Journal, Vol. 24, No. 3, 09.2004, p. 502-505.

Research output: Contribution to journalArticle

Lantuejoul, S, Colby, TV, Ferretti, GR, Brichon, PY, Brambilla, C & Brambilla, E 2004, 'Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing', European Respiratory Journal, vol. 24, no. 3, pp. 502-505. https://doi.org/10.1183/09031936.04.00124703
Lantuejoul S, Colby TV, Ferretti GR, Brichon PY, Brambilla C, Brambilla E. Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing. European Respiratory Journal. 2004 Sep;24(3):502-505. https://doi.org/10.1183/09031936.04.00124703
Lantuejoul, S. ; Colby, T. V. ; Ferretti, G. R. ; Brichon, P. Y. ; Brambilla, C. ; Brambilla, E. / Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing. In: European Respiratory Journal. 2004 ; Vol. 24, No. 3. pp. 502-505.
@article{c20380fae6c549ac8ea854a84c727be4,
title = "Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing",
abstract = "Pulmonary adenocarcinoma of the lung and its variants are well-defined entities, since the recent WHO classification of lung tumours. However, scant descriptions have been allocated to associated stromal changes, such as prominent inflammation and fibrosis, which can overshadow a tumoral proliferation and masquerade as a benign reactive process and this has not been recognised as histopathological variant. The case of a 72-yr-old farmer who presented a multifocal well-differentiated adenocarcinoma that mimicked honeycomb lung with bronchiolectasis radiologically, on computed tomography scan and histologically at open lung biopsy, is reported. Histological pitfalls in the biopsy were represented by mild atypical cuboidal or columnar epithelial cells lining bronchiolar structures resembling florid bronchiolar metaplasia in a background of extensive fibrosis and inflammation, features that mimicked inflammatory honeycombing. However, histological analysis of the surgical resection of the main lesion, performed because of a clinical alteration of the patient, confirmed the diagnosis of multifocal adenocarcinoma of mixed subtype. A monomorphic proliferation of clear cells, lack of associated ciliated or squamous cells and presence of significant cytologic atypia gave a diagnosis of malignancy. This case illustrates how inflammatory and fibrotic changes may conceal a correct diagnosis of carcinoma and emphasises the importance of adequate sampling in such cases.",
keywords = "Honeycombing, Inflammatory stroma, Lung cancer",
author = "S. Lantuejoul and Colby, {T. V.} and Ferretti, {G. R.} and Brichon, {P. Y.} and C. Brambilla and E. Brambilla",
year = "2004",
month = "9",
doi = "10.1183/09031936.04.00124703",
language = "English (US)",
volume = "24",
pages = "502--505",
journal = "European Respiratory Journal",
issn = "0903-1936",
publisher = "European Respiratory Society",
number = "3",

}

TY - JOUR

T1 - Adenocarcinoma of the lung mimicking inflammatory lung disease with honeycombing

AU - Lantuejoul, S.

AU - Colby, T. V.

AU - Ferretti, G. R.

AU - Brichon, P. Y.

AU - Brambilla, C.

AU - Brambilla, E.

PY - 2004/9

Y1 - 2004/9

N2 - Pulmonary adenocarcinoma of the lung and its variants are well-defined entities, since the recent WHO classification of lung tumours. However, scant descriptions have been allocated to associated stromal changes, such as prominent inflammation and fibrosis, which can overshadow a tumoral proliferation and masquerade as a benign reactive process and this has not been recognised as histopathological variant. The case of a 72-yr-old farmer who presented a multifocal well-differentiated adenocarcinoma that mimicked honeycomb lung with bronchiolectasis radiologically, on computed tomography scan and histologically at open lung biopsy, is reported. Histological pitfalls in the biopsy were represented by mild atypical cuboidal or columnar epithelial cells lining bronchiolar structures resembling florid bronchiolar metaplasia in a background of extensive fibrosis and inflammation, features that mimicked inflammatory honeycombing. However, histological analysis of the surgical resection of the main lesion, performed because of a clinical alteration of the patient, confirmed the diagnosis of multifocal adenocarcinoma of mixed subtype. A monomorphic proliferation of clear cells, lack of associated ciliated or squamous cells and presence of significant cytologic atypia gave a diagnosis of malignancy. This case illustrates how inflammatory and fibrotic changes may conceal a correct diagnosis of carcinoma and emphasises the importance of adequate sampling in such cases.

AB - Pulmonary adenocarcinoma of the lung and its variants are well-defined entities, since the recent WHO classification of lung tumours. However, scant descriptions have been allocated to associated stromal changes, such as prominent inflammation and fibrosis, which can overshadow a tumoral proliferation and masquerade as a benign reactive process and this has not been recognised as histopathological variant. The case of a 72-yr-old farmer who presented a multifocal well-differentiated adenocarcinoma that mimicked honeycomb lung with bronchiolectasis radiologically, on computed tomography scan and histologically at open lung biopsy, is reported. Histological pitfalls in the biopsy were represented by mild atypical cuboidal or columnar epithelial cells lining bronchiolar structures resembling florid bronchiolar metaplasia in a background of extensive fibrosis and inflammation, features that mimicked inflammatory honeycombing. However, histological analysis of the surgical resection of the main lesion, performed because of a clinical alteration of the patient, confirmed the diagnosis of multifocal adenocarcinoma of mixed subtype. A monomorphic proliferation of clear cells, lack of associated ciliated or squamous cells and presence of significant cytologic atypia gave a diagnosis of malignancy. This case illustrates how inflammatory and fibrotic changes may conceal a correct diagnosis of carcinoma and emphasises the importance of adequate sampling in such cases.

KW - Honeycombing

KW - Inflammatory stroma

KW - Lung cancer

UR - http://www.scopus.com/inward/record.url?scp=4544311811&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4544311811&partnerID=8YFLogxK

U2 - 10.1183/09031936.04.00124703

DO - 10.1183/09031936.04.00124703

M3 - Article

VL - 24

SP - 502

EP - 505

JO - European Respiratory Journal

JF - European Respiratory Journal

SN - 0903-1936

IS - 3

ER -