title: A primary pure yolk sac tumor of the lung exhibiting CDX-2 immunoreactivity and increased serum levels of alkaline phosphatase intestinal isoenzyme.
abstract: 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.
authors.affiliation: Division of Pathology, European Institute of Oncology and University of Milan School of Medicine, Milan, Italy. giuseppe.pelosi@ieo.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pelosi
authors.forename: Francesco
authors.initials: F
authors.lastname: Petrella
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Sandri
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Spaggiari
authors.forename: Domenico
authors.initials: D
authors.lastname: Galetta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D000071616:CDX2 Transcription Factor; D018398:Homeodomain Proteins; D007527:Isoenzymes; D015534:Trans-Activators; D000469:Alkaline Phosphatase