| Adenocarcinoma |
|
Micrograph of an adenocarcinoma showing mucin containing vacuoles. Pap test.
|
| Classification and external resources |
| Specialty |
Oncology, pathology |
| ICD-9-CM |
151.0, 182.0 |
| ICD-O |
M8140/3 |
| NCI |
Adenocarcinoma |
| MeSH |
D000230 |
Adenocarcinoma[1] (; plural adenocarcinomas or adenocarcinomata ) is a type of cancerous tumor that can occur in several parts of the body. It is defined as neoplasia of epithelial tissue that has glandular origin, glandular characteristics, or both. Adenocarcinomas are part of the larger grouping of carcinomas. Cancers that are adenocarcinomas are often usually called by more precise terms omitting the word, where these exist. Thus invasive ductal carcinoma, the most common form of breast cancer, is adenocarcinoma but does not use the term in its name, but esophageal adenocarcinoma does, to distinguish it from the other common type of esophageal cancer, esophageal squamous cell carcinoma, which is not adenocarcinoma. Several of the most common forms of cancer are adenocarcinomas, and the various sorts of adenocarcinoma vary greatly in all their aspects, so that few useful generalizations can be made about them.
In the most specific usage (narrowest sense), the glandular origin or traits are exocrine; endocrine gland tumors, such as a VIPoma, an insulinoma, or a pheochromocytoma, are typically not referred to as adenocarcinomas but rather are often called neuroendocrine tumors. Epithelial tissue sometimes includes, but is not limited to, the surface layer of skin, glands, and a variety of other tissue that lines the cavities and organs of the body. Epithelial tissue can be derived embryologically from any of the germ layers (ectoderm, endoderm, or mesoderm). To be classified as adenocarcinoma, the cells do not necessarily need to be part of a gland, as long as they have secretory properties. Adenocarcinoma is the malignant counterpart to adenoma, which is the benign form of such tumors. Sometimes adenomas transform into adenocarcinomas, but most do not.
Well differentiated adenocarcinomas tend to resemble the glandular tissue that they are derived from, while poorly differentiated adenocarcinomas may not. By staining the cells from a biopsy, a pathologist can determine whether the tumor is an adenocarcinoma or some other type of cancer. Adenocarcinomas can arise in many tissues of the body owing to the ubiquitous nature of glands within the body, and, more fundamentally, to the potency of epithelial cells. While each gland may not be secreting the same substance, as long as there is an exocrine function to the cell, it is considered glandular and its malignant form is therefore named adenocarcinoma.
Contents
- 1 Histopathology
- 1.1 Breast
- 1.2 Colon
- 1.3 Lung
- 1.4 Other
- 2 Etymology
- 3 See also
- 4 References
- 5 External links
Histopathology
Many seborrheic keratoses on back of person with Leser–Trélat sign due to colon cancer.
Examples of cancers where adenocarcinomas are a common form:
- esophageal cancer; most cases in the developed world are adenocarcinomas.[2]
- pancreas; over 80% of pancreatic cancers are ductal adenocarcinomas.[3]
- prostate cancer is nearly always adenocarcinoma
- Most cervical cancer is squamous cell cancer, but 10–15% of cervical cancers are adenocarcinomas.[4]
- stomach cancer
Breast
Most breast cancers start in the ducts or lobules, and are adenocarcinomas. The three most common histopathological types collectively represent approximately three-quarters of breast cancers:
- Invasive ductal carcinoma: 55% of breast cancers[5]
- Ductal carcinoma in situ: 13%[5]
- Invasive lobular carcinoma: 5%[5]
Colon
Gross appearance of an opened colectomy specimen containing two adenomatous polyps (the brownish oval tumors above the labels, attached to the normal beige lining by a stalk) and one
invasive colorectal carcinoma (the crater-like, reddish, irregularly-shaped tumor located above the label).
Histopathologic image of colonic carcinoid stained by hematoxylin and eosin.
The vast majority of colorectal cancers are adenocarcinomas. This is because the colon has numerous glands within the tissue. Normal colonic glands tend to be simple and tubular in appearance with a mixture of mucus secreting goblet cells and water absorbing cells. These glands are called glands because they secrete a substance into the lumen of the colon, this substance being mucus. The purpose of these glands is twofold. The first is to absorb water from the feces back into the blood. The second purpose is to secrete mucus into the colon lumen to lubricate the now dehydrated feces. This is crucial as a failure to lubricate the feces can result in colonic damage by the feces as it passes towards the rectum.[6]
When these glands undergo a number of changes at the genetic level, they proceed in a predictable manner as they move from benign to an invasive, malignant colon cancer. In their research paper "Lessons from Hereditary Colorectal Cancer", Vogelstein, et al., suggested that colon cells lose the APC tumor suppressor gene and become a small polyp. Next, they suggested that k-Ras becomes activated and the polyp becomes a small, benign adenoma. The adenoma, lacking the "carcinoma" attached to the end of it, suggests that it is a benign version of the malignant adenocarcinoma. The gastroenterologist uses a colonoscopy to find and remove these adenomas and polyps to prevent them from continuing to acquire genetic changes that will lead to an invasive adenocarcinoma. Vogelstein et al. went on to suggest that loss of the DCC gene and of p53 result in a malignant adenocarcinoma.[7]
There will be a mass of a different color to the surrounding tissue. Bleeding from the tumor is often apparent as the tumor tends to grow blood vessels into it in a haphazard manner via secretion of a number of angiogenesis promoting factors such as VEGF. Histologically, tumours resembling the original structures are classified as well differentiated. Tumour cells that have lost any resemblance to original tissue, both in appearance and structure form, are denoted as poorly differentiated tumour cells. Regardless of the grade, malignant tumors tend to have a large nucleus with prominent nucleoli. There will also be a noticeable increase in the incidence of mitosis, or cell divisions.
Lung
Main article: Adenocarcinoma of the lung
Pie chart showing incidence of adenocarcinoma of the lung (shown in yellow) as compared to other lung cancer types, with fractions of non-smokers versus smokers shown for each type.
[8]
Nearly 40% of lung cancers are adenocarcinoma, which usually originates in peripheral lung tissue.[9] Most cases of adenocarcinoma are associated with smoking; however, among people who have smoked fewer than 100 cigarettes in their lifetimes ("never-smokers"),[10] adenocarcinoma is the most common form of lung cancer.[11] A subtype of adenocarcinoma, the bronchioloalveolar carcinoma, is more common in female never-smokers, and may have a better long-term survival.[12]
This cancer usually is seen peripherally in the lungs, as opposed to small cell lung cancer and squamous cell lung cancer, which both tend to be more centrally located.[13][14]
Other
- Cholangiocarcinoma, or bile duct cancer.
- vaginal cancer
- Cancer of the urachus
- Stomach cancer
Etymology
The term adenocarcinoma is derived from adeno-, meaning "pertaining to a gland", and carcinoma, which describes a cancer that has developed in the epithelial cells.
See also
- Clear-cell adenocarcinoma
References
- ^ From adeno-, "gland" and karkin(o)-, "cancerous" and -oma, "tumor".
- ^ World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 5.3. ISBN 9283204298.
- ^ Bond-Smith, G; Banga, N; Hammond, TM; Imber, CJ (May 16, 2012). "Pancreatic adenocarcinoma.". BMJ (Clinical research ed.) 344: e2476. doi:10.1136/bmj.e2476. PMID 22592847.
- ^ World Cancer Report 2014. World Health Organization. 2014. pp. 473–474. ISBN 9283204298.
- ^ a b c Percentage values are from United States statistics 2004. Subtype specific incidences are taken from Table 6 (invasive) and Table 3 (in situ) from Eheman CR, Shaw KM, Ryerson AB, Miller JW, Ajani UA, White MC (June 2009). "The changing incidence of in situ and invasive ductal and lobular breast carcinomas: United States, 1999–2004". Cancer Epidemiol. Biomarkers Prev. 18 (6): 1763–9. doi:10.1158/1055-9965.EPI-08-1082. PMID 19454615. . These are divided by total breast cancer incidence (211,300 invasive and 55,700 in situ cases) as reported from Breast Cancer Facts & Figures 2003–2004 [1]
- ^ Heath JE, Young B, Wheater PR, Lowe JN, Stevens A (2006). Wheater's Functional histology: a text and colour atlas (5th ed.). Edinburgh: Churchill Livingstone Elsevier. p. 283. ISBN 0-443-06850-X.
- ^ Kinzler KW, Vogelstein B (October 1996). "Lessons from hereditary colorectal cancer". Cell 87 (2): 159–70. doi:10.1016/S0092-8674(00)81333-1. PMID 8861899.
- ^ Smokers defined as current or former smoker of more than 1 year of duration. See image page in Commons for percentages in numbers. Reference:
- Table 2 in: Kenfield SA, Wei EK, Stampfer MJ, Rosner BA, Colditz GA (2008). "Comparison of aspects of smoking among the four histological types of lung cancer.". Tob Control 17 (3): 198–204. doi:10.1136/tc.2007.022582. PMC 3044470. PMID 18390646.
- ^ Lu, C; Onn A, Vaporciyan AA et al. (2010). "78: Cancer of the Lung". Holland-Frei Cancer Medicine (8th ed.). People's Medical Publishing House. ISBN 978-1-60795-014-1.
- ^ Horn, L; Pao W; Johnson DH (2012). "Chapter 89". In Longo, DL; Kasper, DL; Jameson, JL; Fauci, AS; Hauser, SL; Loscalzo, J. Harrison's Principles of Internal Medicine (18th ed.). McGraw-Hill. ISBN 0-07-174889-X.
- ^ Subramanian, J; Govindan R (February 2007). "Lung cancer in never smokers: a review". Journal of Clinical Oncology (American Society of Clinical Oncology) 25 (5): 561–570. doi:10.1200/JCO.2006.06.8015. PMID 17290066.
- ^ Raz, DJ; He B; Rosell R; Jablons DM (March 2006). "Bronchioloalveolar carcinoma: a review". Clinical Lung Cancer 7 (5): 313–322. doi:10.3816/CLC.2006.n.012. PMID 16640802.
- ^ Chapter 13, box on morphology of adenocarcinoma in: Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson. Robbins Basic Pathology. Philadelphia: Saunders. ISBN 1-4160-2973-7. 8th edition.
- ^ Travis WD, Travis LB, Devesa SS (January 1995). "Lung cancer". Cancer 75 (1 Suppl): 191–202. doi:10.1002/1097-0142(19950101)75:1+<191::AID-CNCR2820751307>3.0.CO;2-Y. PMID 8000996.
External links
- Media related to Adenocarcinomas at Wikimedia Commons
- "Adenocarcinoma"—NCI Dictionary of Cancer Terms
- Surgical Videos, Images and Case Studies of Adenocarcinoma of the Sinuses
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Glandular and epithelial neoplasms (ICD-O 8010-8589)
|
|
| Epithelium |
Papilloma/carcinoma
(8010-8139) |
- Small cell carcinoma
- Combined small cell carcinoma
- Verrucous carcinoma
- Squamous cell carcinoma
- Basal cell carcinoma
- Transitional cell carcinoma
- Inverted papilloma
|
|
|
| Glands |
Adenomas/
adenocarcinomas
(8140-8429) |
| Gastrointestinal |
- tract: Linitis plastica
- Familial adenomatous polyposis
- pancreas
- Insulinoma
- Glucagonoma
- Gastrinoma
- VIPoma
- Somatostatinoma
- Cholangiocarcinoma
- Klatskin tumor
- Hepatocellular adenoma/Hepatocellular carcinoma
|
|
| Urogenital |
- Renal cell carcinoma
- Endometrioid tumor
- Renal oncocytoma
|
|
| Endocrine |
- Prolactinoma
- Multiple endocrine neoplasia
- Adrenocortical adenoma/Adrenocortical carcinoma
- Hurthle cell
|
|
| Other/multiple |
- Neuroendocrine tumor
- Adenoid cystic carcinoma
- Oncocytoma
- Clear cell adenocarcinoma
- Apudoma
- Cylindroma
- Papillary hidradenoma
|
|
|
Adnexal and
skin appendage (8390-8429) |
- sweat gland
- Syringocystadenoma papilliferum
|
|
Cystic, mucinous,
and serous (8440-8499) |
| Cystic general |
- Cystadenoma/Cystadenocarcinoma
|
|
| Mucinous |
- Signet ring cell carcinoma
- Mucinous cystadenoma / Mucinous cystadenocarcinoma
- Mucoepidermoid carcinoma
|
|
| Serous |
- Ovarian serous cystadenoma / Pancreatic serous cystadenoma / Serous cystadenocarcinoma / Papillary serous cystadenocarcinoma
|
|
|
Ductal, lobular,
and medullary (8500-8549) |
| Ductal carcinoma |
- Mammary ductal carcinoma
- Pancreatic ductal carcinoma
- Comedocarcinoma
- Paget's disease of the breast / Extramammary Paget's disease
|
|
| Lobular carcinoma |
- Lobular carcinoma in situ
- Invasive lobular carcinoma
|
|
| Medullary carcinoma |
- Medullary carcinoma of the breast
- Medullary thyroid cancer
|
|
|
| Acinar cell (8550-8559) |
|
|
|
| Other |
| Complex epithelial (8560-8589) |
|
|
|
- See also
- Template:Epithelium and epithelial tissue
|
|
|
Tumours and neoplasia in the respiratory tract (C30–C34/D14, 160–163/212.0–212.4)
|
|
| Upper RT |
- Nasal cavity
- Esthesioneuroblastoma
- Nasopharynx
- Nasopharyngeal carcinoma
- Nasopharyngeal angiofibroma
- Larynx
- Laryngeal cancer
- Laryngeal papillomatosis
|
|
| Lower RT |
| Trachea |
|
|
| Lung |
| Non-small-cell lung carcinoma |
- Squamous cell carcinoma
- Adenocarcinoma of the lung (Mucinous cystadenocarcinoma)
- Large-cell lung carcinoma
- Rhabdoid carcinoma
- Sarcomatoid carcinoma
- Carcinoid
- Salivary gland-like carcinoma of the lung
- Adenosquamous carcinoma
- Papillary adenocarcinoma
- Giant cell carcinoma
|
|
| Small-cell carcinoma |
- Combined small-cell carcinoma
|
|
| Non-carcinoma |
- Sarcoma
- Lymphoma
- Immature teratoma
- Melanoma
|
|
| By location |
- Pancoast tumor
- Solitary pulmonary nodule
- Central lung
- Peripheral lung
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|
|
|
| Pleura |
- Mesothelioma
- Malignant solitary fibrous tumor
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|
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Index of the respiratory system
|
|
| Description |
- Anatomy
- Physiology
- Development
|
|
| Disease |
- Congenital
- Neoplasms and cancer
- Chest trauma
- Infection
- common cold
- pneumonia
- tuberculosis
- Other
- Symptoms and signs
|
|
| Treatment |
- Procedures
- Drugs
- nasal
- throat
- obstructive airway diseases
- cough and cold
- histaminergics
- pulmonary arterial hypertension
- other
- Surgery
|
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|
|
Digestive system neoplasia (C15–C26/D12–D13, 150–159/211)
|
|
| GI tract |
| Upper |
| Esophagus |
- Squamous cell carcinoma
- Adenocarcinoma
|
|
| Stomach |
- Gastric carcinoma
- Signet ring cell carcinoma
- Gastric lymphoma
- Linitis plastica
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|
|
| Lower |
| Small intestine |
|
|
| Appendix |
- Carcinoid
- Pseudomyxoma peritonei
|
|
| Colon/rectum |
- colorectal polyp: Peutz–Jeghers syndrome
- Juvenile polyposis syndrome
- Familial adenomatous polyposis/Gardner's syndrome
- Cronkhite–Canada syndrome
- neoplasm: Adenocarcinoma
- Familial adenomatous polyposis
- Hereditary nonpolyposis colorectal cancer
|
|
| Anus |
|
|
|
| Upper and/or lower |
- Gastrointestinal stromal tumor
- Krukenberg tumor (metastatic)
|
|
|
| Accessory |
| Liver |
- malignant: Hepatocellular carcinoma
- Hepatoblastoma
- benign: Hepatocellular adenoma
- Cavernous hemangioma
- hyperplasia: Focal nodular hyperplasia
- Nodular regenerative hyperplasia
|
|
| Biliary tract |
- bile duct: Cholangiocarcinoma
- Klatskin tumor
- gallbladder: Gallbladder cancer
|
|
| Pancreas |
- exocrine pancreas: Adenocarcinoma
- Pancreatic ductal carcinoma
- cystic neoplasms: Serous microcystic adenoma
- Intraductal papillary mucinous neoplasm
- Mucinous cystic neoplasm
- Solid pseudopapillary neoplasm
|
|
|
| Peritoneum |
- Primary peritoneal carcinoma
- Peritoneal mesothelioma
- Desmoplastic small round cell tumor
|
|
|
Index of digestion
|
|
| Description |
- Anatomy
- Physiology
- Development
|
|
| Disease |
- Congenital
- Neoplasms and cancer
- Inflammatory bowel disease
- Gluten sensitivity
- Other
- Symptoms and signs
- Blood tests
|
|
| Treatment |
- Procedures
- Drugs
- anabolic steroids
- antacids
- diarrhoea and infection
- bile and liver
- functional gastrointestinal disorders
- laxatives
- peptic ulcer and reflux
- nausea and vomiting
- other
- Surgery
|
|
|
|
Tumors: female urogenital neoplasia (C51–C58/D25–D28, 179–184/218–221)
|
|
| Adnexa |
| Ovaries |
Glandular and epithelial/
surface epithelial-
stromal tumor |
| CMS: |
- Ovarian serous cystadenoma
- Mucinous cystadenoma
- Cystadenocarcinoma
- Papillary serous cystadenocarcinoma
- Krukenberg tumor
|
|
- Endometrioid tumor
- Clear-cell ovarian carcinoma
- Brenner tumour
|
|
|
| Sex cord-gonadal stromal |
- Leydig cell tumour
- Sertoli cell tumour
- Sertoli-Leydig cell tumour
- Thecoma
- Granulosa cell tumour
- Luteoma
- Sex cord tumour with annular tubules
- Steroid cell tumor (NOS)
|
|
| Germ cell |
- Dysgerminoma
- Nongerminomatous
- Embryonal carcinoma
- Endodermal sinus tumor
- Gonadoblastoma
- Teratoma/Struma ovarii
- Choriocarcinoma
|
|
| Fibroma |
|
|
|
| Fallopian tube |
|
|
|
| Uterus |
| Myometrium |
- Uterine fibroids/leiomyoma
- Leiomyosarcoma
- Adenomyoma
|
|
| Endometrium |
- Endometrioid tumor
- Uterine papillary serous carcinoma
- Clear cell carcinoma
- Endometrial intraepithelial neoplasia
|
|
| Cervix |
- Cervical intraepithelial neoplasia
- SCC
- Glassy cell carcinoma
- Villoglandular adenocarcinoma
|
|
| Placenta |
- Choriocarcinoma
- Gestational trophoblastic disease
|
|
| General |
- Uterine sarcoma
- Mixed Müllerian tumor
|
|
|
| Vagina |
- SCC
- Botryoid rhabdomyosarcoma
- Clear cell adenocarcinoma of the vagina
- Vaginal intraepithelial neoplasia
|
|
| Vulva |
- SCC
- Melanoma
- Papillary hidradenoma
- Extramammary Paget's disease
- Vulvar intraepithelial neoplasia
|
|
|
Index of reproductive medicine
|
|
| Description |
- Anatomy
- Physiology
- Development
- sex determination and differentiation
|
|
| Disease |
- Infections
- Congenital
- Neoplasms and cancer
- male
- female
- gonadal
- germ cell
- Other
- Symptoms and signs
|
|
| Treatment |
- Procedures
- Drugs
- benign prostatic hypertrophy
- erectile dysfunction and premature ejaculation
- sexual dysfunction
- infection
- hormones
- androgens
- estrogens
- progestogens
- GnRH
- prolactin
- Assisted reproduction
- Birth control
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