期刊
HISTOPATHOLOGY
卷 83, 期 2, 页码 178-192出版社
WILEY
DOI: 10.1111/his.14890
关键词
bronchiolar adenoma; EGFR exon 20 insertion; pulmonary peripheral squamous cell neoplasm
This study describes a series of rare peripheral pulmonary neoplasms called peripheral type squamous cell neoplasm of uncertain malignant potential (PSCN-UMP) and investigates their relationship with bronchiolar adenoma (BA) and squamous cell carcinoma (SCC). The study found significant differences in histologic, immunohistochemical, and genetic features between PSCN-UMPs, BAs, and SCCs.
IntroductionHerein we describe a series of rare peripheral pulmonary neoplasms temporarily termed peripheral type squamous cell neoplasm of uncertain malignant potential (PSCN-UMP) and investigate their relationship to bronchiolar adenoma (BA) and squamous cell carcinoma (SCC). Materials and MethodsThe histologic and immunohistochemical features of 10 PSCN-UMPs and six BAs were compared. Whole exome sequencing (WES) and bioinformatics analysis were performed to further compare the genetic features of PSCN-UMPs, BAs, and NSCLCs. ResultsAll PSCN-UMPs were peripherally located and histologically characterised by the lepidic, nested, and papillary proliferation of relatively bland squamous cells, accompanied by entrapped hyperplastic reactive pneumocytes. The basal squamous cells coexpressed TTF1 and squamous markers. Both cellular components exhibited bland morphology and a low proliferative activity. The six BAs met the morphologic and immunophenotypic features of proximal-type BA. Genetically, driver mutations, including frequent EGFR exon 20 insertions, were found in PSCN-UMPs, while the KRAS mutation, BRAF mutation, and ERC1::RET fusion were detected in BAs. PSCN-UMPs also shared some alterations with BAs in mutational signatures, while copy number variants (CNV) were enriched in MET and NKX2-1 in PSCN-UMP and MCL1, MECOM, SGK1, and PRKAR1A in BA. ConclusionPSCN-UMPs exhibited the proliferation of bland squamous cells accompanied by entrapped pneumocytes and frequent EGFR exon 20 insertions, which showed distinct features from BAs and SCCs. Recognition of this specific entity will help to expand the morphologic and molecular spectrum of peripheral lung squamous neoplasms.
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