{
  "passages": [
    {
      "id": "lung-luad-definition",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUAD"
      ],
      "topic": "definition",
      "he_observable": true,
      "text": "Lung adenocarcinoma is a non-small cell lung carcinoma that shows glandular differentiation, mucin production, or pneumocyte marker expression (TTF-1 or Napsin A positivity), using the WHO 2021 taxonomy as encoded in the ICCR lung reporting guide.",
      "source_id": "iccr-lung",
      "locator": "histological tumour type section",
      "quote_type": "paraphrase",
      "facts": [
        {
          "s": "lung:LUAD",
          "r": "has_feature",
          "o": "lung:glandular-architecture",
          "he_observable": true
        },
        {
          "s": "lung:LUAD",
          "r": "has_feature",
          "o": "lung:mucin",
          "he_observable": true
        },
        {
          "s": "lung:LUAD",
          "r": "has_feature",
          "o": "lung:ttf1-napsin-positive",
          "he_observable": false
        }
      ]
    },
    {
      "id": "lung-lusc-definition",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUSC"
      ],
      "topic": "definition",
      "he_observable": true,
      "text": "Lung squamous cell carcinoma is a non-small cell lung carcinoma that shows keratinization and/or intercellular bridges, or p40/p63 positivity with TTF-1 and Napsin A negativity, using the WHO 2021 taxonomy as encoded in the ICCR lung reporting guide.",
      "source_id": "iccr-lung",
      "locator": "histological tumour type section",
      "quote_type": "paraphrase",
      "facts": [
        {
          "s": "lung:LUSC",
          "r": "has_feature",
          "o": "lung:keratinization",
          "he_observable": true
        },
        {
          "s": "lung:LUSC",
          "r": "has_feature",
          "o": "lung:intercellular-bridges",
          "he_observable": true
        },
        {
          "s": "lung:LUSC",
          "r": "has_feature",
          "o": "lung:p40-p63-positive",
          "he_observable": false
        }
      ]
    },
    {
      "id": "lung-luad-subtypes",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUAD"
      ],
      "topic": "taxonomy",
      "he_observable": true,
      "text": "The ICCR guide lists these adenocarcinoma categories: adenocarcinoma in situ (non-mucinous or mucinous), minimally invasive adenocarcinoma, invasive non-mucinous adenocarcinoma reported by predominant pattern (lepidic, acinar, papillary, micropapillary, solid) with a percentage for each pattern, invasive mucinous adenocarcinoma, colloid, fetal, and enteric-type adenocarcinoma.",
      "source_id": "iccr-lung",
      "locator": "histological tumour type section",
      "quote_type": "paraphrase",
      "facts": []
    },
    {
      "id": "lung-lusc-subtypes",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUSC"
      ],
      "topic": "taxonomy",
      "he_observable": true,
      "text": "The ICCR guide lists these squamous categories: squamous cell carcinoma in situ, invasive squamous cell carcinoma NOS, keratinizing, non-keratinizing, basaloid, and lymphoepithelial carcinoma.",
      "source_id": "iccr-lung",
      "locator": "histological tumour type section",
      "quote_type": "paraphrase",
      "facts": []
    },
    {
      "id": "lung-luad-grading",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUAD"
      ],
      "topic": "grading",
      "he_observable": true,
      "text": "The IASLC grading system for lung adenocarcinoma uses five patterns: lepidic, acinar, papillary, micropapillary and solid. Grade 1 is lepidic-predominant with no more than 20 percent high-grade patterns. Grade 2 is acinar- or papillary-predominant with no more than 20 percent high-grade patterns. Grade 3 has 20 percent or more high-grade patterns, where high-grade means micropapillary, solid or complex glandular. The study validated it for advanced-stage disease.",
      "source_id": "pmc7698816",
      "locator": "grading system summary",
      "quote_type": "paraphrase",
      "facts": [
        {
          "s": "lung:LUAD",
          "r": "has_feature",
          "o": "lung:acinar-pattern",
          "he_observable": true
        },
        {
          "s": "lung:LUAD",
          "r": "has_feature",
          "o": "lung:lepidic-pattern",
          "he_observable": true
        },
        {
          "s": "lung:LUAD",
          "r": "has_feature",
          "o": "lung:solid-pattern",
          "he_observable": true
        }
      ]
    },
    {
      "id": "lung-luad-cytomorphology",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUAD"
      ],
      "topic": "cytomorphology",
      "he_observable": true,
      "text": "In one Indian cross-sectional cohort, adenocarcinomas showed acinar architecture in 77.1 percent and solid architecture in 85.7 percent of cases, with vacuolated-to-eosinophilic cytoplasm and prominent nucleoli. These percentages come from a single cohort and are not population base rates.",
      "source_id": "pmc12308192",
      "locator": "results, adenocarcinoma morphology",
      "quote_type": "paraphrase",
      "facts": [
        {
          "s": "lung:LUAD",
          "r": "has_feature",
          "o": "lung:prominent-nucleoli",
          "he_observable": true
        },
        {
          "s": "lung:LUAD",
          "r": "has_feature",
          "o": "lung:vacuolated-cytoplasm",
          "he_observable": true
        }
      ]
    },
    {
      "id": "lung-lusc-cytomorphology",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUSC"
      ],
      "topic": "cytomorphology",
      "he_observable": true,
      "text": "In the same cohort, squamous cell carcinomas showed nest-like architecture, individual-cell keratinization (76.6 percent), intercellular bridges (75.4 percent) and keratin pearl formation (78.9 percent). These percentages come from a single cohort and are not population base rates.",
      "source_id": "pmc12308192",
      "locator": "results, squamous morphology",
      "quote_type": "paraphrase",
      "facts": [
        {
          "s": "lung:LUSC",
          "r": "has_feature",
          "o": "lung:nested-growth",
          "he_observable": true
        },
        {
          "s": "lung:LUSC",
          "r": "has_feature",
          "o": "lung:keratin-pearls",
          "he_observable": true
        }
      ]
    },
    {
      "id": "lung-luad-ihc",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUAD"
      ],
      "topic": "immunohistochemistry",
      "he_observable": false,
      "text": "Adenocarcinoma was TTF-1 positive in 94.28 percent and Napsin A positive in 88.57 percent of cases in the cohort, p40 negative, and p63 rarely weak or focal. The study concluded that a TTF-1 plus p40 panel can separate adenocarcinoma from squamous carcinoma while saving tissue for molecular tests. This is not visible on H&E.",
      "source_id": "pmc12308192",
      "locator": "results, immunohistochemistry",
      "quote_type": "paraphrase",
      "facts": []
    },
    {
      "id": "lung-lusc-ihc",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUSC"
      ],
      "topic": "immunohistochemistry",
      "he_observable": false,
      "text": "Squamous carcinoma was p40 positive in 100 percent and p63 positive in 98.21 percent of cases in the cohort, with TTF-1 and Napsin A negative. This is not visible on H&E.",
      "source_id": "pmc12308192",
      "locator": "results, immunohistochemistry",
      "quote_type": "paraphrase",
      "facts": []
    },
    {
      "id": "lung-luad-vs-lusc",
      "datasets": [
        "tcga-nsclc"
      ],
      "entities": [
        "lung:LUAD",
        "lung:LUSC"
      ],
      "topic": "differential",
      "he_observable": true,
      "text": "Squamous carcinoma is separated from adenocarcinoma by keratinization and intercellular bridges, which adenocarcinoma lacks, and adenocarcinoma by glandular or acinar formation and mucin, which squamous carcinoma lacks. When morphology is ambiguous, for example in poorly differentiated solid-pattern tumours, the IHC panel (TTF-1 and Napsin A versus p40 and p63) is the main discriminator.",
      "source_id": "pmc12308192",
      "locator": "discussion, differential diagnosis",
      "quote_type": "paraphrase",
      "facts": [
        {
          "s": "lung:LUSC",
          "r": "distinguished_from",
          "o": "lung:LUAD",
          "feature": "lung:keratinization",
          "he_observable": true
        },
        {
          "s": "lung:LUSC",
          "r": "distinguished_from",
          "o": "lung:LUAD",
          "feature": "lung:intercellular-bridges",
          "he_observable": true
        },
        {
          "s": "lung:LUAD",
          "r": "distinguished_from",
          "o": "lung:LUSC",
          "feature": "lung:glandular-architecture",
          "he_observable": true
        },
        {
          "s": "lung:LUAD",
          "r": "distinguished_from",
          "o": "lung:LUSC",
          "feature": "lung:mucin",
          "he_observable": true
        }
      ]
    }
  ]
}