Papillary Variant of Adenocarcinoma

Definition: Formation of papillary projections is common in BAC, but if the predominant pattern is papillary with complex secondary and tertiary branches, and if necrosis and destruction of lung parenchyma are present, the tumor should be called a papillary carcinoma.

This large papillary projection (large arrow) with a thick core has multiple secondary as well as tertiary (small arrow) branches.

At higher magnification, PMNs are present in the fibrous core and the necrotic exudate outside it. This inflammation and necrosis are not characteristic of BAC.

Histologic Features of Papillary Carcinoma of Lung

Outcome: The disease-free, mean survival of stage I patients (n=15) was 40% at 3.4 y and of stage II patients (n=8) was 25% at 3.5 y. These percentages are less than those for localized BAC.

Reference

Silver S, Askin F. True papillary carcinoma of the lung. A distinct clinicopathologic entity. Am J Surg Pathol 1997; 21:43-51.

Discussion

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