Chapter 5 - Tumors of the Lung and Pleura

Abstract

Cancers of the lung are diverse, with the majority resulting from prolonged tobacco smoke exposure. Cancers that were historically termed non-small cell carcinoma, including adenocarcinoma, squamous cell carcinoma and large cell carcinoma, comprise the majority of malignant neoplasms arising in the lung. Low-grade and high-grade neuroendocrine tumors are less common but are clinically important and pathologically can mimic non-neuroendocrine tumors, mesenchymal tumors and lymphomas. Certain mesenchymal and vascular tumors that are well characterized in extrapulmonary sites also have a predilection for lung or pleural involvement, including inflammatory myofibroblastic tumor, solitary fibrous tumor, and epithelioid hemangioendothelioma. Malignant mesothelioma may arise in any serosal membrane but most commonly involves the pleura where it is highly associated with prior asbestos exposure and almost uniformly lethal. The genomic underpinnings of many of these entities have been well-characterized, facilitating the identification of predictive biomarkers for response to targeted therapies (particularly in lung adenocarcinomas), as well as providing diagnostic markers of particular utility in the workup of mesenchymal neoplasms and lymphoproliferative disorders.