The association between atypical adenomatous hyperplasia and primary lung cancer

Br J Cancer. 2000 Sep;83(5):632-6. doi: 10.1054/bjoc.2000.1317.


Atypical adenomatous hyperplasia (AAH) has been suggested as the adenoma in an adenoma-carcinoma sequence in the lung periphery. From 1989-1998, we undertook a systematic, prospective search for AAH in lungs resected for cancer. AAH was found in 67 of 554 patients (12. 1%) with primary lung carcinoma (9.2% in male patients and 19.0% in females). AAH was found in lungs bearing adenocarcinoma (23.2%) more frequently than with large cell undifferentiated carcinoma (12.5%) or squamous carcinoma (3.3%). A greater percentage of females with adenocarcinoma had AAH (30.2%) than did males with adenocarcinoma (18.8%). Numbers of AAH ranged from 1-42 per patient and more patients had small numbers of AAH, although 12 patients had 6 or more AAH foci. Larger numbers of AAH tended to be found in adenocarcinoma-bearing lungs. Ten of the 67 patients with AAH and primary lung carcinoma (15%) had multiple primary cancers (range 2-6), all of which were adenocarcinoma. Synchronous cancers were rare in lung tumour-bearing resections without AAH. Patients with AAH show no difference in post-operative survival to those without, for all stages of carcinoma and for Stage I disease alone. This study provides evidence for a strong association between atypical adenomatous hyperplasia and primary lung adenocarcinoma and lends weight to the AAH/adenoma-carcinoma hypothesis.

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenomatosis, Pulmonary / complications
  • Adenomatosis, Pulmonary / mortality
  • Adenomatosis, Pulmonary / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Large Cell / complications
  • Carcinoma, Large Cell / mortality
  • Carcinoma, Large Cell / pathology
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Female
  • Humans
  • Hyperplasia / mortality
  • Hyperplasia / pathology*
  • Lung Neoplasms / complications*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Precancerous Conditions / mortality
  • Precancerous Conditions / pathology*
  • Prospective Studies