Lung pathologyIntermediate

Pulmonary adenocarcinoma with lepidic pattern

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Clinical history

70-year-old former smoker with a subsolid nodule on CT.

Specimen

Lobectomy · Stain: H&E and TTF-1

Microscopic description

Neoplastic cells growing along intact alveolar septa with a focal acinar invasive component measuring 7 mm.

Diagnostic question

How is invasive size determined and why does it matter?

Reveal differential diagnosis
  • Adenocarcinoma in situ
  • Minimally invasive adenocarcinoma
  • Reactive pneumocyte hyperplasia
Reveal final diagnosis

Invasive adenocarcinoma, lepidic predominant

Learning points

  • Staging uses invasive size, not total tumour size
  • Record growth pattern percentages
  • Assess pleural and lymphovascular invasion

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