Lung adenocarcinoma with bronchioloalveolar carcinoma component is frequently associated with foci of high-grade atypical adenomatous hyperplasia

Takaomi Koga, Shuichi Hashimoto, Kenji Sugio, Yoshikazu Yonemitsu, Yutaka Nakashima, Ichiro Yoshino, Yoshio Matsuo, Sepideh Mojtahedzadeh, Keizo Sugimachi, Katsuo Sueishi

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We assessed the occurrence of atypical adenomatous hyperplasia (AAH) in whole lung lobes with primary cancer lesions. Following surgical resection, tissue specimens were sliced to a thickness of 4 mm (3,641 specimens from 61 cases; mean = 59.7 specimens per case). A total of 119 AAH foci were found and an association was evident in 25 (57%) of 44 adenocarcinomas, 3 (30%) of 10 squamous cell carcinomas, and 2 (29%) of 7 other lung cancers. Histologic evaluation showed that 108 AAH foci were categorized as low-grade and the other 11 as high-grade AAH. These 11 foci of high-grade AAH were present in 7 patients with adenocarcinoma, and in 1 patient there was a synchronous double primary lung adenocarcinoma. High-grade AAH was closely associated with bronchioloalveolar carcinoma (BAC) type adenocarcinoma, and low-grade AAH with non-BAC adenocarcinoma. The mean ± SD Ki-67 labeling index in high-grade AAH (3.5% ± 2.9%) was significantly higher than for the low-grade index (1.4% ± 1.6%). We propose that foci of high- but not low-grade AAH may be potential precursor lesions of lung adenocarcinoma, especially with the BAC component.

Original languageEnglish
Pages (from-to)464-470
Number of pages7
JournalAmerican Journal of Clinical Pathology
Issue number3
Publication statusPublished - Mar 25 2002


All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

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