title: Aberrant nuclear localization and gene mutation of beta-catenin in low-grade adenocarcinoma of fetal lung type: up-regulation of the Wnt signaling pathway may be a common denominator for the development of tumors that form morules.
abstract: The salient histopathologic features of low-grade adenocarcinoma of the fetal lung type (L-FLAC)/well-differentiated fetal adenocarcinoma (WDFA) include complex glandular structures and morules with biotin-rich optically clear nuclei. Interestingly, these characteristic features are shared by the cribriform-morular variant of papillary thyroid carcinoma, whose morphology is identical to that of familial adenomatous polyposis (FAP)-associated thyroid carcinoma. Furthermore, the single reported case of lung cancer associated with FAP was L-FLAC/WDFA. These observations lead us to hypothesize that up-regulation of the Wnt signaling pathway underlies the development of L-FLAC/WDFA. To verify this hypothesis, 11 cases of L-FLAC/WDFA, including the one FAP-associated case, eight cases of high-grade adenocarcinoma of the fetal lung type (H-FLAC), 24 cases of conventional pulmonary adenocarcinoma (CAC), and 13 fetal lungs were immunostained for beta-catenin. All cases of L-FLAC/WDFA showed predominantly aberrant nuclear/cytoplasmic expression, especially in budding glands and morules, whereas six of eight cases (75%) of H-FLAC and all but one case (96%) of CAC showed predominantly membranous expression. Fetal lungs showed nuclear/cytoplasmic expression restricted to the distal branching airway epithelium. Mutational analysis of exon 3 of the beta-catenin gene in five sporadic cases of L-FLAC/WDFA showed a point mutation at codon 34 and codon 37 in two cases, respectively. The present study indicates that up-regulating disturbances in the Wnt signaling pathway, including mutation of the beta-catenin gene, underlie tumorigenesis of L-FLAC/WDFA. The expression pattern of beta-catenin in L-FLAC/WDFA resembles that of the developing fetal lung airway. With the expression pattern of beta-catenin as a marker, most cases of H-FLAC as well as CAC appear to have different oncogenic pathways from cases of L-FLAC/WDFA. The present study together with other available data also suggests that abnormal up-regulation of the Wnt signaling pathway may be a common denominator for the development of tumors with morular formation from a variety of anatomic sites.
authors.affiliation: Division of Anatomic and Surgical Pathology, Hospital of Yokohama City University, Yokohama City University School of Medicine, Japan. ynak@med.yokohama-cu.ac.jp
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nakatani
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Masudo
authors.forename: Yohei
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inayama
authors.forename: Naomi
authors.initials: N
authors.lastname: Kawano
authors.forename: Yukichi
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kato
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ito
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kitamura
authors.forename: Yoji
authors.initials: Y
authors.lastname: Nagashima
authors.forename: Shoji
authors.initials: S
authors.lastname: Yamanaka
authors.forename: Nobuo
authors.initials: N
authors.lastname: Nakamura
authors.forename: Jinyu
authors.initials: J
authors.lastname: Sano
authors.forename: Nobuo
authors.initials: N
authors.lastname: Ogawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiwa
authors.forename: Kenji
authors.initials: K
authors.lastname: Notohara
authors.forename: Milan
authors.initials: M
authors.lastname: Resl
authors.forename: Eugene J
authors.initials: EJ
authors.lastname: Mark
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D001483:Base Sequence; D002467:Cell Nucleus / Q000378:metabolism*; D003598:Cytoskeletal Proteins / Q000235:genetics* / Q000378:metabolism; D004252:DNA Mutational Analysis; D004273:DNA, Neoplasm / Q000737:chemistry / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000737:chemistry / Q000196:embryology / Q000473:pathology*; D008175:Lung Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D009154:Mutation; D011518:Proto-Oncogene Proteins / Q000378:metabolism; D015398:Signal Transduction; D015534:Trans-Activators / Q000235:genetics* / Q000378:metabolism; D015854:Up-Regulation; D051153:Wnt Proteins; D029961:Zebrafish Proteins; D051176:beta Catenin
chemical_list: C495270:CTNNB1 protein, human; D003598:Cytoskeletal Proteins; D004273:DNA, Neoplasm; D011518:Proto-Oncogene Proteins; D015534:Trans-Activators; D051153:Wnt Proteins; D029961:Zebrafish Proteins; D051176:beta Catenin