Molecular profiling in lung cancer associated with cystic airspaces

ABSTRACT

‘Lung cancer associated with cystic airspaces’ is a rare radiological entity that is more frequently encountered on imaging studies and is gaining more attention since the widespread use of CT for lung cancer screening. Numerous aspects of this entity remain unraveled, including molecular profiling. The goal of this observational retrospective single-center case series is to investigate the molecular profile of lung cancers presenting with this specific morphology in a Caucasian population. Between January 2014 and May 2017, 13 patients were presented at the Multidisciplinary Thoracic Oncology Tumor Board with imaging findings consistent with ‘lung cancer associated with cystic airspaces’. Electronic medical files were reviewed for patient characteristics, stage, histopathological findings and – in particular – molecular profiling. Histopathological diagnosis showed adenocarcinoma in 11 patients in our series. Mutational analysis in 10 showed different molecular alterations: an EGFR exon 18 mutation, ROS1 rearrangement and BRAF mutation in one patient each. Two patients showed KRAS mutations. With 5 out of 10 patients with an adenocarcinoma presenting with cystic airspace morphology showing a molecular alteration, this may indicate that in this subgroup, molecular profiling is mandatory, regardless of smoking history.

KEYWORDS:

• Adenocarcinoma
• lung cancer associated with cystic airspaces
• imaging
• molecular profiling
• computed tomography

Acknowledgments

The authors thank Karen Zwaenepoel and Koen Dewinne for their assistance regarding the methodology of molecular profiling.

Author Contributions

Concept: all authors

Data acquisition: AS, PR

Data analysis and interpretation, all authors

Manuscript preparation: ASN, PR, JVM

Manuscript editing: all authors

Manuscript review: all authors

Disclosure statement

No potential conflict of interest was reported by the authors.

Statement of Ethics

Collection of data was approved by the Institutional Review Board and the requirement for informed consent was waived (EC18/34/381)