What question did this study set out to answer?

Investigate cases of central lung adenocarcinoma in nonsmoking women and associated genomic characteristics.

May 20, 2026American Journal of Respiratory and Critical Care Medicine0 citations

C79-21 Lung Central Adenocarcinoma in Two Nonsmoker Women

MQM A QuiñonezUniversidad Católica de Honduras Nuestra Señora Reina de la Paz ACA CarbajalHonduras Foundation for Agricultural Research SRS RomeroHonduras Foundation for Agricultural Research

Key Points

Investigate cases of central lung adenocarcinoma in nonsmoking women and associated genomic characteristics.
Detailed case studies of two nonsmoking women with lung adenocarcinoma, including imaging, pathology, and treatment.
Pathological analysis confirmed diagnoses with IHC and NGS panel testing.
Both cases explored treatment responses and outcomes.
Both cases showed non-small cell lung cancer (NSCLC) adenocarcinoma in stage III A.
EGFR mutation found in the first case with TKI therapy, patient died after 9 months.
Second case received first-line chemotherapy with negative NGS results, illustrating variability in genetic profiles.

Abstract

Abstract Lung cancer (LC) is the leading cause of cancer-related death worldwide and it is the second most common cancer among men and women in many countries. Lung cancer in nonsmoking individuals (people who never smoked or smoked less than 100 cigarettes in their lifetime) accounts for 15% to 20% of all lung cancers. Histologically adenocarcinoma (ADC) is the most common type in this group. CASE 1 A 31-year-old nonsmoker female presented with a two-month history of dry cough, fatigue, weight loss and one week before admission to the hospital had mild hemoptysis and exertional dyspnea. Imaging studies revealed a mass in the middle lobe of the right lung with ipsilateral mediastinal lymph node swelling. Bronchoscopy revealed extrinsic compression of the main carina with mucosal infiltration of the right bronchus with 50% reduction of its lumen. Pathology analysis of biopsy confirmed NSCLC ADC, IHC TTF-1 positive, P40 negative. LC NGS panel reported EGFR positive (LR858R mutation, exon 21). Advanced disease (stage III A) was established and TKI erlotinib was initiated, unfortunately the patient died 9 months later due to progression of the disease. CASE 2: A 54-year-old nonsmoker woman starts with a six-week history of progressive nonproductive cough, chest oppression, fatigue, no associated weight loss. A chest CT showed a subcarinal mass and segmental atelectasis of the right middle lobe. Bronchoscopy examination revealed extrinsic compression and irregular appearance of the main carina and extrinsic compression of the intermedius bronchus with mucosal tumor infiltration and reduction of 60% of its lumen. Histology confirmed a non-small cell carcinoma (NSCLC), IHC favors ADC (TTF-1 positive, Napsine A positive, P40 negative). NGS panel (18 genes) and PDL-1 IHC analysis was performed and reported negative. She started on first-line platinum-based standard chemotherapy for TNM stage III A disease. Lung ADC in nonsmoking individuals are more common in women. The proportion of central lung ADC has been gradually increasing due to the overall increasing incidence of pulmonary ADC. Among patients with LC, nonsmoking individuals are more likely to have genomic alterations that may improve survival with novel therapies. However, recent studies have suggested that the prognosis of patients with central ADC is poorer compared with peripheral lung ADC. This abstract is funded by: None

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