Heterogeneity of epidermal growth factor receptor mutations within a mixed adenocarcinoma lung nodule.
It has been proposed that stepwise progression occurs from atypical adenomatous hyperplasia (AAH) through bronchioloalveolar carcinoma (BAC) to invasive lung adenocarcinoma. However, the underlying molecular mechanisms have not been identified. We report a patient with a mixed adenocarcinoma of the lung that had different EGFR mutations in the papillary subtype, the acinar subtype, and the surrounding AAH and BAC areas. EGFR mutations may accumulate during tumor progression and lead to heterogeneity of EGFR mutations within the tumor.
Nakano
Hirofumi
H
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
Soda
Hiroshi
H
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan; Division of Respiratory Medicine, Sasebo City General Hospital, Sasebo 857-8511, Japan. Electronic address: h-souda@hospital.sasebo.nagasaki.jp.
Takasu
Mineyo
M
Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8521, Japan.
Tomonaga
Nanae
N
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
Yamaguchi
Hiroyuki
H
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
Nakatomi
Katsumi
K
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
Fujino
Satoru
S
Internal Medicine, Saint Francisco Hospital, Nagasaki 852-8125, Japan.
Hayashi
Tomayoshi
T
Department of Pathology, Nagasaki University Hospital, Nagasaki 852-8501, Japan.
Nakamura
Yoichi
Y
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
Tsukamoto
Kazuhiro
K
Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8521, Japan.
Kohno
Shigeru
S
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
D000230:Adenocarcinoma / Q000235:genetics* / Q000473:pathology; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000235:genetics* / Q000473:pathology; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology; D008875:Middle Aged; D009154:Mutation; D003074:Solitary Pulmonary Nodule / Q000235:genetics* / Q000473:pathology
D066246:ErbB Receptors