Morules, or morule-like features, can be identified in benign and malignant lesions in various organs. Morular features are unusual in pulmonary adenocarcinoma cases with only 26 cases reported to date. Here, we describe two cases of pulmonary adenocarcinoma with morule-like features in Korean women. One patient had a non-mucinous-type adenocarcinoma in situ and the other had an acinarpredominant adenocarcinoma with a micropapillary component. Both patients showed multiple intra-alveolar, nodular, whorled proliferative foci composed of atypical spindle cells with eosinophilic cytoplasm. Targeted next-generation sequencing was performed on DNA extracted from formalin-fixed paraffin-embedded samples of the tumors. Results showed unusual epidermal growth factor receptor (EGFR) mutations, which are associated with drug resistance to EGFR tyrosine kinase inhibitors, revealing the importance of identifying morule-like features in pulmonary adenocarcinoma and the need for additional study, since there are few reported cases.
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Pulmonary adenocarcinoma in situ with morule - like components: A surgical case report Mitsuteru Yosida, Mitsuru Tomita, Naoya Kawakita, Teruki Shimizu, Ryou Yamada, Hiromitsu Takizawa, Hisanori Uehara Respiratory Medicine Case Reports.2024; 48: 102008. CrossRef
Clinicopathological, Radiological, and Molecular Features of Primary Lung Adenocarcinoma with Morule-Like Components Li-Li Wang, Li Ding, Peng Zhao, Jing-Jing Guan, Xiao-Bin Ji, Xiao-Li Zhou, Shi-Hong Shao, Yu-Wei Zou, Wei-Wei Fu, Dong-Liang Lin, Dong Pan Disease Markers.2021; 2021: 1. CrossRef
Adenocarcionma of fetal type is in lung is a newly recognized malignant tumor sharing morphologic features with the epithelial component of the pulmonary blastoma devoid of sarcomatous component. We present a case of adenocarcinoma of fetal type in a 28-year-old female, consisting of numerous branching tubules or glands and morula-like epithelial complexes. Histologically, the tubules and glands were composed of glycogne-rich nonciliated epithelial cells showing in part argyrophilia. Some of tubular and morula-like epithelial cells revealed immunoreactivity for neuron-specific enolase. We report this case with a review of literatures with special references on the histogenisis.
This report is the pathologically confirmed second case of the pulmonary adenocarcinoma of fetal type in Korea, following the report of Cho and Lee, 1990.