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Lung carcinoma is the most common and lethal malignancy in men. Non-small cell lung carcinoma is moreaggressive than small cell lung carcinoma and often presents in advanced stage with metastasis. Cytology,histopathology, immunohistochemistry and metabolic imaging play an important role in classifying lungcarcinomas. TTF 1 and Napsin A are highly sensitive and specific for adenocarcinoma lung, but thesensitivity and specificity decreases in high grade tumours. Elevated serum CA 19-9 tumour marker isnot always related to pancreatico-biliary adenocarcinomas. It can be positive in adenocarcinoma lung andits elevation confers poor prognosis. Quintessential role of metabolic imaging like 18F-FDG PET CT scanin high grade carcinomas is well known. With the advent of targeted therapy, molecular and receptor studiesof EGFR, ROS 1 and ALK gene rearrangement becomes mandatory in all lung adenocarcinomas. Hence,both oncologist and pathologist should diagnose advanced stage tumours without bias with good clinical,radiological and pathological correlation.Keywords: Lung adenocarcinoma, Immunohistochemistry, CA 19-9, TTF1, Napsin A, Metabolic imaging.

indian journal of pathology and oncology

Conflicting immunohistochemistry and metabolic imaging parameters in adenocarcinoma lung showing elevated serum CA 19-9 with immunonegative TTF1 and Napsin A