Different histopathology but the same clonality: ALK rearrangement in a patient with metastatic non-small-cell lung cancer

Jing Zhao; Jianya Zhou; Zhen Chen; Bo Wang; Xiuming Zhang; Jianying Zhou; Wei Ding

Different histopathology but the same clonality: ALK rearrangement in a patient with metastatic non-small-cell lung cancer

Int J Clin Exp Pathol. 2015 Mar 1;8(3):3344-8. eCollection 2015.

Authors

Jing Zhao¹, Jianya Zhou², Zhen Chen¹, Bo Wang¹, Xiuming Zhang¹, Jianying Zhou², Wei Ding¹

Affiliations

¹ Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
² Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.

PMID: 26045865
PMCID: PMC4440174

Abstract

EML4-ALK rearrangement is detected in 2% to 7% of lung adenocarcinomas, these tumors are sensitive to crizotinib. The histologic feature of ALK translocated non-small-cell lung cancer (NSCLC) has been studied, presence of signet-ring cells was a powerful histologic indicator of ALK rearrangement, and this characteristic histology was present both in primary sites and metastases. However, the case we discribed here has different histomorphology in primary sites and metastases, but has the same genotype which both present ALK rearrangement, while absent of EGFR mutation, KRAS mutation and ROS1 rearrangement. This histologic heterogeneity may be a supplement of the histologic feature of ALK rearranged tumor. Moreover, genomic analysis can help distinguish clonal tumors from independent primaries.

Keywords: ALK rearrangement; Lung adenocarcinoma; histology; metastasis.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adenocarcinoma / enzymology
Adenocarcinoma / genetics*
Adenocarcinoma / secondary*
Adenocarcinoma of Lung
Adult
Anaplastic Lymphoma Kinase
Biomarkers, Tumor / genetics*
Biopsy
Carcinoma, Non-Small-Cell Lung / enzymology
Carcinoma, Non-Small-Cell Lung / genetics*
Carcinoma, Non-Small-Cell Lung / secondary*
DNA Mutational Analysis
ErbB Receptors / genetics
Gene Rearrangement*
Genetic Predisposition to Disease
Humans
Immunohistochemistry
In Situ Hybridization, Fluorescence
Lung Neoplasms / enzymology
Lung Neoplasms / genetics*
Lung Neoplasms / pathology*
Male
Mutation
Phenotype
Predictive Value of Tests
Protein-Tyrosine Kinases / genetics
Proto-Oncogene Proteins / genetics
Proto-Oncogene Proteins p21(ras) / genetics
Receptor Protein-Tyrosine Kinases / genetics*
Reverse Transcriptase Polymerase Chain Reaction
Tomography, X-Ray Computed

Substances

Biomarkers, Tumor
KRAS protein, human
Proto-Oncogene Proteins
ALK protein, human
Anaplastic Lymphoma Kinase
EGFR protein, human
ErbB Receptors
Protein-Tyrosine Kinases
ROS1 protein, human
Receptor Protein-Tyrosine Kinases
Proto-Oncogene Proteins p21(ras)