Morphological and genetic heterogeneity of synchronous multifocal lung adenocarcinoma in a Chinese cohort

Abstract Background Synchronous multifocal lung cancer (SMLC) is diagnosed with increasing frequency in clinical practice globally. Due to innate variation management and outcome, it vital properly distinguish between synchronous primary (SMPLC) intrapulmonary metastasis (IM). The pathologic features principal classification criteria of remain unclear. Our objective was evaluate the diagnostic value histological morphologic driver gene mutations SMLC classification. Methods We collected a unique cohort Chinese patients SMLC, fully explored morphologic, immunohistochemical, molecular disease. Twenty-one total 50 tumours were included our study. pathological that presented by these analysed, including location, size, types, predominant pattern adenocarcinoma, immunohistochemical staining. conducted testing nine oncogenes are associated cancer, namely, EGER, KRAS, BRAF, NRAS, ALK, ROS1, RET, HER2, PIK3CA. Results According Martini-Melamed refined standard, 8 17 patients, respectively, considered have SMPLCs. Gene identified 18 (36%). Twelve had different mutations. Conclusions demonstrate conventional morphological assessment not sufficient clearly establish clonal relationship Instead, evaluation subtypes, nonmucinous adherent components, required. Multiplex genotypic analysis may also prove be useful additional tool.