p16 loss promotes transformation and tumorigenesis of RB1-deficient lung epithelial cells. (a, b) Representative low (a) and high (b) power images of subcutaneous tumors arising after injection of Rb1/p16-deficient lung epithelial cells into three independent mice showing histologic features of pleomorphic non-small cell lung cancer (NSCLC) including malignant giant cells with markedly enlarged nuclei (arrows) and spindled cells (arrowheads) invading host adipose tissue (ad) and skeletal muscle (sm). (c–j) Representative lung tumors and metastases in Rb1Δ/Δp16+/− and Rb1Δ/Δp16−/− mice. Pleomorphic NSCLC (c) with metastasis to chest wall (d, e) and histologic features similar to subcutaneous tumors, including giant cells with enlarged nuclei (arrows) and spindled cells (arrowheads) invading skeletal muscle (sm). Gross image of small cell lung cancer (SCLC) (f, t) replacing right lower lung lobe with adjacent normal middle lung lobe (lu) and mediastinal metastasis (met). Multifocal non-small cell lung (NSCL) tumors with extensive airway invasion (g–h, t) and a second mouse with multifocal NSCL tumors (i, t) including adenocarcinoma metastasis (j, met) to mediastinal lymph node (j, ln). (k–n) Representative lung tumors in Rb1Δ/Δp16+/+ mice. One or two tumors (k, t) per mouse were present with papillary and/or solid growth (l) lacking the marked cytological atypia seen in Rb1/p16-deficient tumors (m) and only focal invasion of airway (n). (o) Small cell lung (SCL) and NSCL tumors (t) in a single Rb1Δ/Δp16+/− mouse showing characteristic morphology and immunostaining for CALCA but not SCGB1A1 and SFTPC in SCL tumor and SFTPC but not SCGB1A1 and CALCA in NSCL tumor (representative of 4 SCL and 16 NSCL tumors including 4 metastatic tumors). Original magnifications: × 2 (g, i, k); × 10 (h and o left column); × 20 (a, c, j, l, n); × 40 (O right 4 columns); × 100x (b, d, e, m).