Last updated March 15, 2022

Diagnostic Surgical Pathology In Lung Cancer: Diagnosis And Management Of Lung Cancer

Recommendations

Pathologic Staging

When pathologically diagnosing patients with lung cancer, the synoptic reporting of histologic type, tumor size and location, tumor grade (if appropriate), lymphovascular invasion, pleural involvement, surgical margins, and status and location of lymph nodes is recommended. (1, B)
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Malignant Mesothelioma vs Adenocarcinoma

In individuals with pleural-based tumors, a designated limited panel of histochemical and immunohistochemical assays or ultrastructural analysis is recommended to distinguish between pleural adenocarcinoma and malignant mesothelioma in order to increase diagnostic accuracy. (1, B)
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Small Cell Vs Non-small Cell Carcinoma

In individuals with parenchymal-based tumors, distinguishing between small cell carcinoma and non-small cell carcinoma of the lung is recommended. For challenging cases, a diagnostic panel of immunohistochemical assays or ultrastructural analysis is recommended to increase the diagnostic accuracy. (1, B)
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Adenocarcinoma, AIS (Bronchioloalveolar Carcinoma), and MIAs (minimally invasive adenocarcinomas)

For individuals with glandular producing tumors, distinguishing AIS and MIAs from invasive adenocarcinomas is recommended. (1, C)
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Adenocarcinoma vs Squamous Cell Carcinoma of the Lung

In individuals with pathologically diagnosed NSCLC, additional discrimination between adenocarcinoma and squamous cell carcinoma, even on cytologic material or small tissue samples, is recommended. (1, B)
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Primary vs Metastatic Lung Cancer

For individuals with lung tumors whose differential includes primary lung carcinoma vs metastatic carcinoma, a directed panel of immunohistochemical assays is recommended to increase the diagnostic accuracy. (1, C)
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Recommendation Grading

Overview

Title

Diagnostic Surgical Pathology In Lung Cancer: Diagnosis And Management Of Lung Cancer

Authoring Organization

Publication Month/Year

May 1, 2013

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

This article provides evidence-based background and recommendations for the development of American College of Chest Physicians guidelines for the diagnosis and management of lung cancer. 

Target Patient Population

Patients with lung cancer

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Operating and recovery room, Outpatient, Radiology services

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Diagnosis, Management

Diseases/Conditions (MeSH)

D013903 - Thoracic Surgery, D018787 - Radiation Oncology, D011827 - Radiation, D008175 - Lung Neoplasms

Keywords

lung cancer, surgery, radiation therapy, Adjuvant Radiation Therapy