198 Chapter 14 The prevalence of AIS in our study cohort was high with 10 out of 70 cases (14.3%) is higher than previously reported incidences of AIS in NSCLC (1-8%)337, but similar to the 16% reported by Murikami et al7 and by Yambayev et al. for adenocarcinoma when “low malignant potential” is included336. Verifying the hypotheses regarding iatrogenic collapsed AIS with 100% recurrencefree survival has a limitation. Resection of non-mucinous adenocarcinomas may lead to cure, and the presence of invasive characteristics without metastases is not excluded by the disease-free survival rate. This implies that the lack of recurrence is not synonymous with the absence of invasion. Conclusion Our results showed that iatrogenic collapsed AIS forms a complex wrinkled morphology. The use of elastin and CK7 staining aids in the recognition of iatrogenic collapsed AIS and the distinction from invasive adenocarcinoma. Awareness of iatrogenic collapsed AIS is important, as these patients are cured after resection. Further studies are necessary to determine whether the proposed modified classification improves pattern recognition accuracy, and lifts the long-lasting fog.
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