lewis-x-antigen and Adenocarcinoma--Bronchiolo-Alveolar

Surgical specimens of 7 cases of bronchioalveolar carcinoma complicated with pulmonary fibrosis and 4 cases of simple pulmonary fibrosis were examined histopathologically and immunohistochemically. The morphology and histogenesis of adenomatous hyperplasia (AH) of alveolar epithelium and its relation to bronchioalveolar carcinoma were investigated. The AH was classified as types I and II according to their microscopic morphologic characteristics. In this group, 6 cases of type I-AH and 5 cases of type II-AH were observed. The results of anti-SA, anti-SSEA-1 and anti-CEA monoclonal antibody examinations indicate that AH is a nonspecific hyperplastic lesion of alveolar epithelium occurred during chronic pulmonary inflammatory diseases. Both type I and II AH originated from type B alveolar epithelial cells. The latter developed on the basis of the former, but with a more immature tendency and hyperplastic potential, being a pre-malignant alteration. It could be considered that certain cases of bronchioalveolar carcinoma are originated from type B alveolar epithelial cells, some of which underwent malignant change from type II alveolar hyperplasia.

Topics: Adenocarcinoma, Bronchiolo-Alveolar; Aged; Apoproteins; Carcinoembryonic Antigen; Epithelium; Female; Humans; Hyperplasia; Immunohistochemistry; Lewis X Antigen; Lung Neoplasms; Male; Middle Aged; Precancerous Conditions; Pulmonary Alveoli; Pulmonary Fibrosis; Pulmonary Surfactant-Associated Proteins; Pulmonary Surfactants

The distinction of bronchioloalveolar carcinoma (BAC) from atypical adenomatous hyperplasia (AAH) or reactive alveolar cell hyperplasia (RAH) can be difficult on aspiration cytology, even when cell block preparations are available. The authors evaluated the usefulness of B72.3, carcinoembryonic antigen (CEA), and Leu M-1 immunostains in differentiating BAC, AAH, and RAH.. Immunostains for B72.3, CEA, and Leu M-1 were performed on cell block sections from 11 lung lesions that were diagnosed cytologically as BAC (6 lesions) and "atypical cells, cannot exclude BAC" (5 lesions). Ten histologic sections of AAH and 8 histologic sections of RAH also were stained.. Among the six lesions that had an unequivocal cytologic diagnosis of BAC, all sections were positive for two of three immunostains. Tissue follow-up confirmed BAC in all six lesions. Among the five lesions that were diagnosed as "atypical cells, cannot exclude BAC," four lesions were positive for two of three immunostains, and one lesion was negative for all three immunostains. Subsequent tissue follow-up confirmed BAC in four of these lesions. Follow-up histology of the wedge resection on the lesion in the atypical category that was negative for B72.3, CEA, and Leu M-1 showed only AAH. All 10 lesions that had a histologic diagnosis of AAH and 8 lesions that had a histologic diagnosis RAH were negative for B72.3, CEA, and Leu M-1.. Positive staining for at least 2 immunostains among B72.3, CEA, and Leu M-1 provided strong supportive evidence for the diagnosis of BAC, and a negative result for all 3 immunostains was helpful in excluding BAC and in differentiating BAC from AAH and RAH.

Topics: Adenocarcinoma, Bronchiolo-Alveolar; Antibodies, Neoplasm; Biomarkers, Tumor; Biopsy, Fine-Needle; Carcinoembryonic Antigen; Diagnosis, Differential; Humans; Lewis X Antigen; Lung Neoplasms

Bronchopulmonary carcinomas were analyzed immunohistochemically using monoclonal antibody 624A12. The antibody was raised against a human "small cell carcinoma" cell line NCI-H69. It recognizes a particular sugar sequence in lacto-N-fucopentose III, which is preserved in formalin fixed and paraffin embedded tissue. Various bronchopulmonary carcinomas revealed characteristic patterns of immunoreactivity. Forty nine/50 adenocarcinomas were immunoreactive either diffusely or focally. The immunostaining was usually limited to the cell membranes with occasional intracytoplasmic immunostaining in large cells. The only negative case had been irradiated before surgical resection. Twenty seven/38 squamous cells carcinomas did not immunostain while the remaining 11 displayed focal immunoreactivity in areas of "loose cellular apposition" associated with necrosis and, rarely, in squamous pearls. All of six adenosquamous carcinomas showed immunoreactivity focally. Eleven/30 large cell carcinomas and 10/11 bronchiolo-alveolar carcinomas were either diffusely or focally immunoreactive. Seven/26 intermediate cell neuroendocrine carcinomas were focally immunoreactive while none of 33 typical small cell neuroendocrine carcinomas, 21 carcinoids, and 10 well differentiated neuroendocrine carcinomas was immunoreactive. An adenoid cystic carcinoma was diffusely immunoreactive, and a mucoepidermoid carcinoma was focally immunoreactive. We conclude that various bronchopulmonary neoplasms have characteristic patterns of distribution of this antigen, and that monoclonal antibody 624A12 may be useful for the differential diagnose among bronchopulmonary carcinomas, and their differential diagnosis from pleural mesotheliomas.

Topics: Adenocarcinoma; Adenocarcinoma, Bronchiolo-Alveolar; Animals; Antibodies, Monoclonal; Carcinoma; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Cell Line; Humans; Lewis X Antigen; Lung Neoplasms; Mice; Mice, Nude; Oligosaccharides