Pulmonary Pathology An Atlas and Text THIRD EDITION Editor-in-Chief Philip T. Cagle, MD Professor, Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas Associate Editors Timothy C. Allen, MD, JD Professor and Chair, Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi 2 Mary Beth Beasley, MD Professor, Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York Alain Borczuk, MD Professor of Pathology, Department of Pathology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York Yasmeen M. Butt, MD Assistant Professor, Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas Sanja Dacic, MD, PhD Professor of Pathology, Department of Pathology, University of Pittsburgh, Staff Pathologist, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Aliya N. Husain, MD Professor, Department of Pathology, University of Chicago, Chicago, Illinois Brandon T. Larsen, MD, PhD Assistant Professor, Department of Laboratory Medicine and Pathology, Mayo Clinic School of Medicine, Senior Associate Consultant, Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, 3 Scottsdale, Arizona Ross A. Miller, MD Assistant Professor, Pathologist, Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas Mari Mino-Kenudson, MD Associate Professor, Department of Pathology, Harvard Medical School, Director, Pulmonary Pathology Service, Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts Sergio Pina-Oviedo, MD Assistant Professor, Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas Kirtee Raparia, MD Associate Pathologist, Department of Pathology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California Natasha Rekhtman, MD, PhD Associate Attending Pathologist, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York Anja C. Roden, MD Associate Professor, Consultant, Department of Laboratory Medicine and 4 Pathology, Mayo Clinic, Rochester, Minnesota Sinchita Roy-Chowdhuri, MD, PhD Assistant Professor, Department of Pathology, University of Texas MD Anderson 
 Cancer Cente r, Hou st on, Te xas Lynette M. Sholl, MD Associate Pathologist, Department of Pathology, Brigham and Women’s Faulkner Hospital, Boston, Massachusetts Maxwell L. Smith, MD Associate Professor, Department of Laboratory Medicine and Pathology, Mayo Clinic School of Medicine, Consultant, Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, Arizona 5 Table of Contents Cover image Title page Copyright Dedication Contributing Authors Preface to the Third Edition Preface to the First Edition Acknowledgments Section 1 Normal Cytology and Histology Sinchita Roy-Chowdhuri Chapter 1 Bronchus Chapter 2 Bronchioles and Alveolar Ducts Chapter 3 Blood Vessels and Lymphatics 6 Chapter 4 Alveoli Chapter 5 Pleura Chapter 6 Normal Cytology of the Lung and Pleura Section 2 Artifacts and Age-Related Changes Sinchita Roy- Chowdhuri Chapter 7 Procedural and Laboratory Artifacts Chapter 8 Reactive Changes, Nonspecific Findings, and Age-Related Changes Chapter 9 Noncellular Structures Section 3 Malignant Neoplasms Mari Mino-Kenudson, Sergio Pina- Oviedo, Sanja Dacic, Timothy C. Allen, Ross A. Miller, Philip T. Cagle Chapter 10 Adenocarcinoma Part 1. Lepidic Adenocarcinoma Part 2. Acinar Adenocarcinoma Part 3. Papillary Adenocarcinoma Part 4. Micropapillary Adenocarcinoma Part 5. Solid Adenocarcinoma Part 6. Invasive Mucinous Adenocarcinoma Part 7. Colloid Adenocarcinoma Part 8. Fetal Adenocarcinoma Part 9. Enteric Adenocarcinoma Part 10. Signet Ring and Clear Cell Features Chapter 11 Squamous-Cell Carcinoma Part 1. Keratinizing Squamous-Cell Carcinoma 7 Part 2. Nonkeratinizing Squamous-Cell Carcinoma Part 3. Basaloid Squamous-Cell Carcinoma Chapter 12 Adenosquamous Carcinoma Chapter 13 Large-Cell Carcinoma Chapter 14 Neuroendocrine Carcinomas Part 1. Small-Cell Carcinoma Part 2. Carcinoid Tumor Part 3. Atypical Carcinoid Tumor Part 4. Large-Cell Neuroendocrine Carcinoma Chapter 15 Sarcomatoid Carcinomas Part 1. Carcinosarcoma Part 2. Pulmonary Blastoma Part 3. Pleomorphic Carcinoma Chapter 16 Salivary Gland–Type Cancers Part 1. Adenoid Cystic Carcinoma Part 2. Mucoepidermoid Carcinoma Part 3. Epithelial–Myoepithelial Carcinoma Chapter 17 Lymphoepithelioma-Like Carcinoma Chapter 18 NUT Carcinoma Chapter 19 Primary Pulmonary Sarcomas Part 1. Inflammatory Myofibroblastic Tumor Part 2. Pleuropulmonary Blastoma Part 3. Epithelioid Hemangioendothelioma Part 4. Kaposi Sarcoma 8 Part 5. Synovial Sarcoma Part 6. Malignant Solitary Fibrous Tumor Part 7. Intimal Sarcoma Part 8. SMARCA4-Deficient Thoracic Sarcoma Part 9. Primary Pulmonary Myxoid Sarcoma with EWSR1- CREB1 Translocation Chapter 20 Secondary Pulmonary Sarcomas Part 1. Leiomyosarcoma Part 2. Angiosarcoma Part 3. Osteosarcoma Part 4. Chondrosarcoma Part 5. Liposarcoma Part 6. Malignant Peripheral Nerve Sheath Tumor Part 7. Rhabdomyosarcoma Part 8. Undifferentiated Soft Tissue Sarcoma Part 9. Ewing Sarcoma Chapter 21 Other Pulmonary Sarcomas Part 1. Alveolar Soft Part Sarcoma Part 2. Clear Cell Sarcoma Part 3. Desmoplastic Small Round Cell Tumor Part 4. Extrarenal Rhabdoid Tumor Part 5. Chordoma Part 6. Extraskeletal Myxoid Chondrosarcoma Chapter 22 Pulmonary B-Cell Lymphomas Part 1. Primary and Secondary Lung Involvement 9 Subpart 1.1. Extranodal Marginal Zone Lymphoma (MZL) of the Mucosa-Associated Lymphoid Tissue (MALT Lymphoma) Subpart 1.2. Diffuse Large B-Cell Lymphoma (DLBCL) Subpart 1.3. Lymphomatoid Granulomatosis (LyG) Part 2. Systemic B-Cell Lymphomas with Secondary Lung Involvement Subpart 2.1. Small B-Cell Lymphomas Subpart 2.2. Other B-Cell Lymphomas Chapter 23 Pulmonary Classical Hodgkin Lymphoma Chapter 24 Pulmonary T-Cell Lymphomas Part 1. Peripheral T-cell Lymphoma, NOS Part 2. Systemic T-cell Lymphomas with Secondary Lung Involvement Subpart 2.1. Pulmonary (Visceral) Involvement by Mycosis Fungoides/Sézary Syndrome Subpart 2.2. Pulmonary Anaplastic Large-Cell Lymphoma (ALCL) Chapter 25 Pulmonary Plasma Cell Neoplasms and Related Conditions Part 1. Primary Pulmonary Plasma Cell Neoplasms Part 2. Systemic Plasma Cell Neoplasm with Secondary Lung Involvement Chapter 26 Other Systemic Hematolymphoid Neoplasms with Secondary Lung Involvement Part 1. Acute Leukemia or Myeloproliferative Neoplasms Subpart 1.1. Acute Leukemia Subpart 1.2. Myeloproliferative Neoplasms Chapter 27 Other Neoplasms of the Lung 10