Lung and pleural cancers: Histopathology and immunohistochemistry profile in Kinshasa

Introduction Bronchopulmonary and pleural cancers represent a major public health problem worldwide. In the Democratic Republic of the Congo (DRC), few studies have focused on these pathologies, and no recent data were found in our review. The frequency and predominant histological types of bronchopulmonary cancers remain unknown. Purpose This study aimed to determine the histopathological profile of bronchopulmonary cancers in Kinshasa, with the goal of establishing their frequency, histological types, and levels of tissue infiltration. Methods This descriptive case series was conducted in Kinshasa across three histopathological laboratories: the University Clinic of Kinshasa, Nganda Hospital Centre, and the Leboma Laboratory. The study covered a 12-year period from 2012 to 2024. Results Bronchopulmonary cancers accounted for 1.4% of all tumoural and non-tumoural pathologies recorded during the study period. Among 182 patients, bronchopulmonary adenocarcinoma was the most common histological type (77%). Both adenocarcinomas and squamous cell carcinomas were primary lung cancers. Mesothelioma was the only primary malignancy of pleural tissue, affecting 12 patients (12%). The most affected age group comprised individuals over 60 years, followed by those aged 51–60 years. Conclusion Non-small cell lung carcinoma (NSCLC) was the most frequently reported cancer type in this study. Immunohistochemical markers are critical for establishing accurate differential and definitive diagnoses, particularly to distinguish NSCLC from malignant mesothelioma, which can share overlapping clinical and histological features. Our findings underscore a significant public health concern: lung and pleural cancers in Kinshasa often affect relatively young patients and are typically diagnosed at advanced, invasive stages. Treatment options remain limited, and prognosis is generally poor. There is an urgent need to strengthen early detection programmes, improve access to quality histopathological diagnosis, and raise awareness among both healthcare professionals and the general population regarding the warning signs of these cancers. Enhanced early management could substantially improve patient outcomes.