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Diagnostics
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Selected Topics in Thoracic Pathology
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Selected Topics in Thoracic Pathology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 13680

Special Issue Editor

Prof. Dr. Cesar A. Moran

E-Mail Website
Guest Editor
University of Texas MD Anderson Cancer Center, Houston, TX, USA
Interests: thoracic pathology (lung, pleura, and mediastinum)
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The practice of thoracic pathology is challenging, as this anatomical area is not only a host for primary neoplasms, but also a common location for metastatic disease. In addition, the thoracic cavity hosts different anatomical structures that by themselves can give rise to neoplasms of different lineages. Often, the practice of thoracic pathology needs to be aided by good and reliable diagnostic imaging assessment, which becomes crucial in the final interpretation of the different pathologies that can occur in the lung, pleura, or mediastinum. In this Special Issue of “Selected Topics in Thoracic Pathology”, we aim to highlight the different pathological process that can represent a challenge in interpretation. These challenges are not necessarily seen only in neoplastic conditions, but such challenges may also be encountered in non-neoplastic, reactive, or infectious processes.

Prof. Dr. Cesar A. Moran
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • lung
  • pleura
  • mediastinum
  • immunohistochemistry
  • neoplastic
  • non-neoplastic

Published Papers (7 papers)

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Review

17 pages, 9380 KiB  
Review
Lung Cancer Staging: Imaging and Potential Pitfalls
by Lauren T. Erasmus, Taylor A. Strange, Rishi Agrawal, Chad D. Strange, Jitesh Ahuja, Girish S. Shroff and Mylene T. Truong
Diagnostics 2023, 13(21), 3359; https://doi.org/10.3390/diagnostics13213359 - 01 Nov 2023
Cited by 1 | Viewed by 1585
Abstract
Lung cancer is the leading cause of cancer deaths in men and women in the United States. Accurate staging is needed to determine prognosis and devise effective treatment plans. The International Association for the Study of Lung Cancer (IASLC) has made multiple revisions [...] Read more.
Lung cancer is the leading cause of cancer deaths in men and women in the United States. Accurate staging is needed to determine prognosis and devise effective treatment plans. The International Association for the Study of Lung Cancer (IASLC) has made multiple revisions to the tumor, node, metastasis (TNM) staging system used by the Union for International Cancer Control and the American Joint Committee on Cancer to stage lung cancer. The eighth edition of this staging system includes modifications to the T classification with cut points of 1 cm increments in tumor size, grouping of lung cancers associated with partial or complete lung atelectasis or pneumonitis, grouping of tumors with involvement of a main bronchus regardless of distance from the carina, and upstaging of diaphragmatic invasion to T4. The N classification describes the spread to regional lymph nodes and no changes were proposed for TNM-8. In the M classification, metastatic disease is divided into intra- versus extrathoracic metastasis, and single versus multiple metastases. In order to optimize patient outcomes, it is important to understand the nuances of the TNM staging system, the strengths and weaknesses of various imaging modalities used in lung cancer staging, and potential pitfalls in image interpretation. Full article
(This article belongs to the Special Issue Selected Topics in Thoracic Pathology)
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27 pages, 12663 KiB  
Review
Diagnostic Approach to Pulmonary B-Cell Lymphomas in Small Biopsies, with Practical Recommendations to Avoid Misinterpretation
by Sergio Pina-Oviedo, Victor L. Roggli, Thomas A. Sporn, Huihua Li, Carolyn Glass, Louis R. DiBernardo and Elizabeth N. Pavlisko
Diagnostics 2023, 13(21), 3321; https://doi.org/10.3390/diagnostics13213321 - 26 Oct 2023
Cited by 1 | Viewed by 1143
Abstract
Pulmonary lymphomas are rare. With the current less invasive approaches used to obtain material for diagnosis, the diagnosis of pulmonary lymphoma is now frequently established in a small biopsy rather than in a resection. Therefore, the diagnosis has become more challenging and requires [...] Read more.
Pulmonary lymphomas are rare. With the current less invasive approaches used to obtain material for diagnosis, the diagnosis of pulmonary lymphoma is now frequently established in a small biopsy rather than in a resection. Therefore, the diagnosis has become more challenging and requires correlation with the clinico-radiologic presentation and with ancillary studies (immunohistochemistry, flow cytometry, cytogenetics, and/or molecular analysis). Due to the rarity of pulmonary lymphomas, clinical suspicion of a lymphomatous process is low at initial presentation, and material may be only submitted for histopathology. For this reason, herein, we provide recommendations to arrive at the correct diagnosis of the most common lung B-cell lymphomas (marginal zone lymphoma of mucosa-associated lymphoid tissue, diffuse large B-cell lymphoma, intravascular large B-cell lymphoma, lymphomatoid granulomatosis) in the setting of small biopsies, utilizing only immunohistochemistry. The differential diagnosis varies according to the lymphoma subtype and includes reactive conditions, solid tumors, and other hematolymphoid malignancies. Although morphology and immunohistochemistry may be sufficient to establish a diagnosis, in some cases, the best recommendation is to obtain additional tissue via a VATS biopsy/wedge resection with material submitted for flow cytometry, cytogenetics, and/or molecular studies to be able to properly classify a pulmonary lymphoid process. Full article
(This article belongs to the Special Issue Selected Topics in Thoracic Pathology)
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17 pages, 17363 KiB  
Review
Spectrum of Imaging Patterns of Lung Cancer following Radiation Therapy
by Taylor A. Strange, Lauren T. Erasmus, Jitesh Ahuja, Rishi Agrawal, Girish S. Shroff, Mylene T. Truong and Chad D. Strange
Diagnostics 2023, 13(20), 3283; https://doi.org/10.3390/diagnostics13203283 - 23 Oct 2023
Viewed by 1499
Abstract
Radiation therapy using conventional or newer high-precision dose techniques, including three-dimensional conformal radiotherapy, intensity-modulated radiation therapy, stereotactic body radiation therapy, four-dimensional conformational radiotherapy, and proton therapy, is an important component of treating patients with lung cancer. Knowledge of the radiation technique used and [...] Read more.
Radiation therapy using conventional or newer high-precision dose techniques, including three-dimensional conformal radiotherapy, intensity-modulated radiation therapy, stereotactic body radiation therapy, four-dimensional conformational radiotherapy, and proton therapy, is an important component of treating patients with lung cancer. Knowledge of the radiation technique used and the expected temporal evolution of radiation-induced lung injury, as well as patient-specific parameters such as previous radiotherapy, concurrent chemoradiotherapy, or immunotherapy, is important in image interpretation. This review discusses factors that affect the development and severity of radiation-induced lung injury and its radiological manifestations, as well as the differences between conventional and high-precision dose radiotherapy techniques. Full article
(This article belongs to the Special Issue Selected Topics in Thoracic Pathology)
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18 pages, 14434 KiB  
Review
Approach to Imaging of Mediastinal Masses
by Jitesh Ahuja, Chad D. Strange, Rishi Agrawal, Lauren T. Erasmus and Mylene T. Truong
Diagnostics 2023, 13(20), 3171; https://doi.org/10.3390/diagnostics13203171 - 11 Oct 2023
Cited by 1 | Viewed by 3672
Abstract
Mediastinal masses present a diagnostic challenge due to their diverse etiologies. Accurate localization and internal characteristics of the mass are the two most important factors to narrow the differential diagnosis or provide a specific diagnosis. The International Thymic Malignancy Interest Group (ITMIG) classification [...] Read more.
Mediastinal masses present a diagnostic challenge due to their diverse etiologies. Accurate localization and internal characteristics of the mass are the two most important factors to narrow the differential diagnosis or provide a specific diagnosis. The International Thymic Malignancy Interest Group (ITMIG) classification is the standard classification system used to localize mediastinal masses. Computed tomography (CT) and magnetic resonance imaging (MRI) are the two most commonly used imaging modalities for characterization of the mediastinal masses. Full article
(This article belongs to the Special Issue Selected Topics in Thoracic Pathology)
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13 pages, 6138 KiB  
Review
Thymoma: An Overview
by Doaa Alqaidy
Diagnostics 2023, 13(18), 2982; https://doi.org/10.3390/diagnostics13182982 - 18 Sep 2023
Cited by 2 | Viewed by 2042
Abstract
Thymomas are considered one of the most prevalent types of mediastinal epithelial tumors, which frequently develop in the anterior mediastinum. Due to their rarity, these tumors’ nomenclature, classification, and staging are likely to be the subject of debate and argument for most expert [...] Read more.
Thymomas are considered one of the most prevalent types of mediastinal epithelial tumors, which frequently develop in the anterior mediastinum. Due to their rarity, these tumors’ nomenclature, classification, and staging are likely to be the subject of debate and argument for most expert pathologists. Furthermore, the significance of thymoma histologic classifications have been debated over the past twenty years. While certain advocates argue that staging at the time of diagnosis is more significant, others believe that histologic subtyping has a significant impact on how patients behave clinically. In this review, we will focus on some of the challenges that diagnostic surgical pathologists may experience while evaluating the histopathology of thymomas and staging these tumors. We will additionally glance over the clinical characteristics of these distinct tumors and the current management strategy. Full article
(This article belongs to the Special Issue Selected Topics in Thoracic Pathology)
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26 pages, 14601 KiB  
Review
Primary Pulmonary Carcinomas with Spindle and/or Giant Cell Features: A Review with Emphasis in Classification and Pitfalls in Diagnosis
by Cesar A. Moran
Diagnostics 2023, 13(15), 2477; https://doi.org/10.3390/diagnostics13152477 - 26 Jul 2023
Viewed by 974
Abstract
Primary carcinomas of the lung are vastly represented by the conventional types of adenocarcinomas or squamous cell carcinomas. However, there are other types of non-small cell carcinomas that although uncommon represent a meaningful group that often pose a problem not only in diagnosis [...] Read more.
Primary carcinomas of the lung are vastly represented by the conventional types of adenocarcinomas or squamous cell carcinomas. However, there are other types of non-small cell carcinomas that although uncommon represent a meaningful group that often pose a problem not only in diagnosis but also in classification. Spindle cell and/or giant cell carcinomas, although uncommon represent an important group of primary lung carcinomas. Important to highlight is that current criteria are rather ambiguous and likely not up to date, which renders the classification of these tumors somewhat more obscure. In addition, with the daily use of immunohistochemical stains, the classification of these tumors may also pose a different problem in the proper allocation of these tumors. Proper classification is highly important in the selection process that takes place using such material for molecular analysis. The current molecular characteristics of these tumors are limited and lack more in-depth studies and analyses that can provide specific targets for the treatment of patients with these tumors. The current review attempts to highlight the shortcomings in the current classification and definitions of these neoplasms as well as the more current view regarding these tumors when the use of immunohistochemical stains is employed. Full article
(This article belongs to the Special Issue Selected Topics in Thoracic Pathology)
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31 pages, 8512 KiB  
Review
The Utility of Fine Needle Aspiration (FNA) Biopsy in the Diagnosis of Mediastinal Lesions
by Uma Kundu, Qiong Gan, Deepak Donthi and Nour Sneige
Diagnostics 2023, 13(14), 2400; https://doi.org/10.3390/diagnostics13142400 - 18 Jul 2023
Viewed by 1956
Abstract
Fine needle aspiration is a minimally invasive, low-morbidity, and cost-efficient technique for the sampling of mediastinal lesions. Additionally, ancillary testing on FNA samples can be used for the refinement of diagnoses and for treatment-related purposes (flow cytometry, cytogenetics, immunohistochemistry, and molecular diagnostics). Mediastinal [...] Read more.
Fine needle aspiration is a minimally invasive, low-morbidity, and cost-efficient technique for the sampling of mediastinal lesions. Additionally, ancillary testing on FNA samples can be used for the refinement of diagnoses and for treatment-related purposes (flow cytometry, cytogenetics, immunohistochemistry, and molecular diagnostics). Mediastinal lesions, however, can show a variety of lineages and morphologic features, giving rise to diagnostic dilemmas. As a result, the differential diagnosis can vary widely and becomes especially challenging due to the smaller sample size on FNA and the variability in component sampling. For appropriate patient management and to determine the correct treatment strategies, accurate pathologic diagnoses are paramount. In this review, we present the cytomorphologic features together with the immunophenotypic findings of mediastinal lesions, with emphasis on the diagnostic challenges and pitfalls in FNA cytology samples, including smears and cell block sections. Full article
(This article belongs to the Special Issue Selected Topics in Thoracic Pathology)
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