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P. Reyntiens
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P3.13 - Radiology/Staging/Screening (ID 729)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.13-008 - Lung Cancer Associated with Cystic Airspaces: Clinical, Imaging, Histopathological and Molecular Correlation (ID 8202)
09:30 - 09:30 | Author(s): P. Reyntiens
- Abstract
Background:
“Lung cancer associated with cystic airspaces” is a rare radiological entity that is becoming more frequently encountered on imaging studies and has been gaining more attention since the widespread use of CT for lung cancer screening. The goal of this retrospective study is to investigate and correlate clinical, imaging, histopathological and molecular findings in patients presenting with this type of lung cancer.
Method:
Between January 2014 and April 2017, 13 patients presented at the Multidisciplinary Thoracic Oncology Tumour Board with this rare entity. Clinical, histopathological and molecular data were collected and imaging studies were reviewed for the presence of emphysema, size, morphologic classification and findings on [18]F-FDG-PET.
Result:
Median age at the time of diagnosis was 69 years (53-86 years) with a male/female ratio of 8:5. Ten out of 13 patients were smokers. Eleven patients (11/13) had no previous oncological history. Two patients with previous oncological history both had a history of head-and-neck and stage IA lung cancer. Imaging findings showed emphysema in 7 cases. Four patients had type I, 1 patient type II, 4 type III and 4 type IV morphology. Median diameter for the type I, II, III and IV lesions was 20 mm (17-43), 20 mm, 60 mm (25-67) and 46 mm (37-77) respectively. Lesions were more frequent in the right upper (4/13) and lower lobe (4/13). FDG-PET-scan was available in 11 patients and showed high uptake in all patients who presented with a solid aspect of the associated tumour. Four patients (4/13) presented with stage IV at diagnosis. Other stages varied: IA (4/10), IB (1/10), IIA (1/10), IIIA (2/10) and IIIB (1/10). Adenocarcinoma was found in 11 patients (11/13) and squamous cell carcinoma in 2 (2/13). Molecular genotyping for EGFR, ALK and ROS-1 was available in 10 patients (10/13). None of the patients showed positivity for ALK-immunohistochemistry. A single patient showed an exon-18 mutation in the EGFR gene. One patient showed a translocation at the 6q22 breakpoint of the ROS-1 gene. In one patient, a p.Gly469Ala B-RAF mutation was present. Two patients showed a mutation in the exon 2 of the KRAS gene (exon2 c/35G>C;p.Gly 12Ala and c/35G>T;p.Gly 12Val).
Conclusion:
In this series, 5 out of 10 patients with a “lung cancer associated with cystic airspaces” showed a molecular alteration. This suggests that targeted molecular profiling is mandatory in this subgroup. Larger series are needed to confirm these findings.
