A primary pure yolk sac tumor of the lung exhibiting CDX-2 immunoreactivity and increased serum levels of alkaline phosphatase intestinal isoenzyme.
Malignant extragonadal germ cell tumors primary to the lung are quite uncommon lesions, but pure yolk sac tumor is even more exceptional. This is believed to be the first reported case of yolk sac tumor of the lung in which an intense and diffuse immunoreactivity for CDX2, a marker of intestinal differentiation reportedly expressed also in gonadal yolk sac tumor, was associated with increased serum levels of the alkaline phosphatase intestinal isoform. Nine months after radical surgery and adjuvant chemotherapy, the patient is alive and well without evidence of recurrent or metastatic disease and with serum levels of the alkaline phosphatase intestinal isoform within normal limits. The pathologist should be aware of yolk sac tumor arising in the lung and that alkaline phosphatase intestinal isoform could become an additional serum marker for such a tumor.
Pelosi
Giuseppe
G
Division of Pathology, European Institute of Oncology and University of Milan School of Medicine, Milan, Italy. giuseppe.pelosi@ieo.it
Petrella
Francesco
F
Sandri
Maria Teresa
MT
Spaggiari
Lorenzo
L
Galetta
Domenico
D
Viale
Giuseppe
G
D000469:Alkaline Phosphatase / Q000097:blood*; D014408:Biomarkers, Tumor / Q000378:metabolism; D000071616:CDX2 Transcription Factor; D003131:Combined Modality Therapy; D018240:Endodermal Sinus Tumor / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D018398:Homeodomain Proteins / Q000378:metabolism*; D006801:Humans; D007422:Intestines / Q000201:enzymology*; D007527:Isoenzymes / Q000097:blood; D008175:Lung Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015534:Trans-Activators / Q000378:metabolism*; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D000071616:CDX2 Transcription Factor; D018398:Homeodomain Proteins; D007527:Isoenzymes; D015534:Trans-Activators; D000469:Alkaline Phosphatase