Comment on “Pulmonar collision tumor” and “Well-differentiated fetal adenocarcinoma”

Introdução

Blanco et al. from Vigo¹ and Ouazzani e al. from Rabat² show how Bronchial-Pulmonary Carcinomas are dealt with nowadays. They discuss the cases of a 38 years old woman with a very rare Well Differentiated Fetal Adenocarcinoma (the unique carcinoma referred with a differentiation grade in the WHO 2004 Classification of lung tumors) and a 56 years old man presenting two metastasis of a right maxillary sinus Adenoid Cystic Carcinoma after a gap of 11 years. These two cases are reviewed in parallel with a Pleomorphic Carcinoma of the lung (WHO 2004 – glandular neoplastic proliferation – Adenocarcinoma – with large cells with severe atypical cytology – with pleomorphic elements), which required immunohistochemistry for correct diagnosis and carcinogenic understanding. It is fortunate that surgical specimens give Modern Pathology an open laboratory so that the consequences of carcinogenic stimulation can be understood – nothing happens by chance – and the prognosis arrived at by a combination of morphology, immunostaining, molecular actual validation and pTNM, under the Pathologist's supervision. Embryology and adult potential stem cells expressions are now recognised as research tools in the interpretation of the histopathology of all benign and malignant tumors and the two examples under consideration, were obviously diagnosed based on fetal mimicking morphology which, together with multiple specific different patterns correlated with different immonohistochemical specificities in the first case, and in the second case, the expressions of TTF1/NKX: the latter is a gene related to brain/thyroid/lung embryological development and the c-kit gene, which is compromised of stem cells...