Colliding primary lung cancers of adenosquamous carcinoma and large cell neuroendocrine carcinoma.
We report an extremely rare case of primary lung cancer showing various histological elements diagnosed as the collision of an adenosquamous carcinoma and a large cell neuroendocrine carcinoma by loss of heterozygosity (LOH) analysis of the human androgen receptor (AR) and phosphoglycerate kinase (PGK-1) genes. The tumor exhibited a tiny ground-glass opaque shadow suggesting atypical adenomatous hyperplasia 18 months prior to surgery. However, the tumor grew rapidly, and the resected tumor consisted of two closely located nodules. The larger nodule was composed of well-differentiated adenocarcinomatous and moderately to poorly differentiated squamous cell carcinomatous elements, while the smaller nodule consisted of a large cell neuroendocrine carcinomatous element with partial squamoid differentiation having focal continuity with the adenocarcinomatous element. Both the adenocarcinomatous and squamous cell carcinomatous elements revealed transitional features and LOH of AR and PGK-1 genes, while the large cell neuroendocrine carcinomatous element showed a monoclonal pattern but possessed both alleles of AR and PGK-1 genes. From these clinical and pathological results, the parental cell of the large cell neuroendocrine carcinomatous element was considered to be different from that of the adenosquamous carcinomatous element.
Yazawa
Takuya
T
Department of Pathology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan. tkyazawa@med.yokohama-cu.ac.jp
Ishii
Haruhiko
H
Ito
Takaaki
T
Yoshiike
Yasuhiro
Y
Ogawa
Nobuo
N
Okudela
Koji
K
Hayashi
Hiroyuki
H
Suzuki
Takehisa
T
Mitsui
Hideaki
H
Ikeda
Masaichi
M
Kitamura
Hitoshi
H
D000595:Amino Acid Sequence; D001483:Base Sequence; D018196:Carcinoma, Adenosquamous / Q000235:genetics / Q000556:secondary* / Q000601:surgery; D018278:Carcinoma, Neuroendocrine / Q000235:genetics / Q000556:secondary* / Q000601:surgery; D002999:Clone Cells; D017931:DNA Primers; D004273:DNA, Neoplasm / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D015894:Genome, Human; D006801:Humans; D019656:Loss of Heterozygosity; D008175:Lung Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D010735:Phosphoglycerate Kinase / Q000032:analysis / Q000235:genetics; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D011944:Receptors, Androgen / Q000032:analysis / Q000235:genetics
D017931:DNA Primers; D004273:DNA, Neoplasm; D011944:Receptors, Androgen; D010735:Phosphoglycerate Kinase