A punch biopsy from a lung lesion comes back describing malignant cells arranged in nests with intercellular bridges and focal keratin pearls, noted as moderately differentiated, with mitoses visible in several high-power fields. The staging conference needs this entered correctly in the treatment record. Which statement matches the tumor's histologic type and grade?

Pathology hands you two separate facts for the record, and blending them is the usual way this topic goes wrong. Histologic type comes from what the cells are doing, and nests of cells joined by intercellular bridges with keratin pearls are the signature of squamous differentiation, which makes the type squamous cell carcinoma. Grade comes from how far the tissue has drifted from its normal appearance, and the pathologist has already called that drift moderately differentiated while noting mitotic activity in several fields. The adenocarcinoma approach fails because gland formation and mucin production, not bridges and pearls, define that lineage, and grade rests on overall differentiation rather than a mitotic count alone, even though the wording here matches. The staging approach confuses grade with stage, since TNM describes how far disease has spread rather than how abnormal the cells look. The well-differentiated approach fails because it lets one feature override the stated overall picture; keratin pearls confirm squamous origin but do not by themselves raise the grade. Exam caveat: grading vocabularies vary by organ site and some reports use numeric or tiered systems, so follow the final report's wording. Practical check: when you enter data, copy type and grade into separate fields and verify both against the signed report.