{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:58:12Z","timestamp":1789487892191,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["pathsocjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pathology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Bronchiolar adenoma (BA) is a rare benign pulmonary neoplasm defined by a bilayered architecture with a continuous basal cell layer. Increasingly, BA\u2010like lesions with atypical features have been recognized, challenging established diagnostic boundaries and raising questions regarding their malignant potential. In this study, we investigated the clinicopathological and molecular characteristics of such lesions. We retrospectively analyzed 19 BA\u2010like lesions that retained at least focal classic BA morphology and exhibited one or more predefined atypical features, including basal cell hyperplasia (with or without squamous dysplasia), partial\u2010to\u2010complete loss of the basal cell layer, stromal\u2010like growth, cytological atypia exceeding classic BA, or morphologically contiguous carcinoma components. Patients showed a broad age distribution with a slight female predominance, and all cases with available follow\u2010up remained disease\u2010free following complete surgical resection (median 29.6\u2009months; range 5\u201364\u2009months). Histologically, atypical changes involved both basal and luminal compartments, resulting in mixed biphasic and monolayered areas, stromal\u2010like growth, squamous metaplasia or dysplasia, and variable degrees of cytological atypia. Whole\u2010exome sequencing (10 cases) and targeted profiling (two cases) revealed heterogeneous genetic alterations, including driver events involving\n                    <jats:italic>BRAF<\/jats:italic>\n                    ,\n                    <jats:italic>EGFR<\/jats:italic>\n                    , and\n                    <jats:italic>MET<\/jats:italic>\n                    , as well as recurrent mutations affecting\n                    <jats:italic>HRAS<\/jats:italic>\n                    ,\n                    <jats:italic>PIK3CA<\/jats:italic>\n                    ,\n                    <jats:italic>MTOR<\/jats:italic>\n                    , DNA repair genes, and epigenetic regulators. Pathogenic\n                    <jats:italic>TP53<\/jats:italic>\n                    mutations were confined to lesions with marked epithelial atypia. At the pathway level, MAPK alterations, including\n                    <jats:italic>HRAS<\/jats:italic>\n                    mutations, were enriched in basal\u2010hyperplasia lesions, whereas PI3K\/AKT\/mTOR alterations were more frequent in basal\u2010deficient lesions. These findings support the concept that BA\u2010like lesions with atypical features represent a morphological continuum ranging from benign BA to malignant lesions. We further propose a pragmatic framework for diagnosis and clinical management, although validation in larger cohorts with longer follow\u2010up is required. \u00a9 2026 The Pathological Society of Great Britain and Ireland.\n                  <\/jats:p>","DOI":"10.1002\/path.70092","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T09:58:02Z","timestamp":1783504682000},"page":"194-210","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bronchiolar adenoma\u2010like lesions with atypical features beyond the classic morphological spectrum: integrating histomorphology and molecular profiles"],"prefix":"10.1002","volume":"270","author":[{"given":"Jiayu","family":"Li","sequence":"first","affiliation":[{"name":"Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunzhu","family":"Li","sequence":"additional","affiliation":[{"name":"Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqin","family":"Tan","sequence":"additional","affiliation":[{"name":"Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengmin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohong","family":"Yao","sequence":"additional","affiliation":[{"name":"Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4580-275X","authenticated-orcid":false,"given":"Ting","family":"Lan","sequence":"additional","affiliation":[{"name":"Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000414"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001086"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.11.003"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1617720"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-23-374"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14890"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2022.154079"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cjp2.197"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.13956"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pin.12708"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.21972"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkq603"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkv1189"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature15393"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature19057"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2308-7"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkv1222"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gky1015"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkg509"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nmeth0410-248"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2023.10.038"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pulmoe.2023.10.007"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14907"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.15075"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14921"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.modpat.2023.100354"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2024.05.001"},{"key":"e_1_2_8_29_1","first-page":"1465","article-title":"Clinicopathological features and genomic analysis of bronchiolar adenoma","volume":"38","author":"Bo J","year":"2023","journal-title":"Histol Histopathol"},{"key":"e_1_2_8_30_1","first-page":"1024","article-title":"Bronchiolar adenoma with atypical and malignant components: clinicopathological analysis of 4 cases","volume":"53","author":"Zhao J","year":"2024","journal-title":"Zhonghua Bing Li Xue Za Zhi"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/1066896920988359"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1491339"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.2147\/OTT.S299864"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-021-01687-5"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v11.i1.233"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.15037"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-023-01347-1"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-018-04128-5"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12010093"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12943-023-01827-6"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1565549"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atssr.2022.10.006"}],"container-title":["The Journal of Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pathsocjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/path.70092","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/pathsocjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/path.70092","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/pathsocjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/path.70092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:32:47Z","timestamp":1789482767000},"score":1,"resource":{"primary":{"URL":"https:\/\/pathsocjournals.onlinelibrary.wiley.com\/doi\/10.1002\/path.70092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/path.70092"],"URL":"https:\/\/doi.org\/10.1002\/path.70092","archive":["Portico"],"relation":{},"ISSN":["0022-3417","1096-9896"],"issn-type":[{"value":"0022-3417","type":"print"},{"value":"1096-9896","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"assertion":[{"value":"2025-11-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}