Is lung cancer heterogeneity a chaotic process?

Speculative fractal explanation

James Fleck, MD, PhD: Anticancerweb 07(09), 2021

The fractal pattern is present throughout nature. These two leopards may not be exactly alike, but self-similarity leads to immediate species identification. In fact, the leopard skin pattern is fractal, a rough or fragmented geometric shape that can be divided into parts, each of which is a reduced-size copy of the whole, as defined by Benoît Mandelbrot. In 1980, the mathematician moved to IBM, where he used complex numbers and quadratic polynomials to build an infinite iteration image. This image, known as Mandelbrot set, was the first to reproduce in an electronic system the fractal geometry found in nature. Fractal geometry is defined by multiple levels of organization, irregular shapes and self-similarity. Transposed to biological models, this phenotypic expression is present in both health and disease. Tumor cells have fractal expression, which allows the identification of specific patterns used in pathological diagnosis. Let’s take lung adenocarcinoma as an experimental model. Tumor heterogeneity was identified in light microscopy in former described five histologic subtypes (lepidic, acinar, papillary, micropapillary and solid). Each subtype is an iteration image making possible specific morphologic diagnosis.