title: Anaplastic lymphoma kinase gene analysis as a useful tool for identifying primary unknown metastatic lung adenocarcinoma.
abstract: A 55-year-old woman was admitted for an evaluation of a mediastinal mass, bilateral cervical lymphadenopathy and a left breast tumor. Although pathology revealed a diagnosis of breast cancer, the cervical lymph nodes differed from the breast lesion. An anaplastic lymphoma kinase (ALK) gene analysis revealed ALK rearrangement in the cervical lymph nodes only, which were therefore diagnosed as reflective of metastasis of lung adenocarcinoma. The mediastinal tumor was also diagnosed as an ALK-positive lung adenocarcinoma based on its therapeutic response. ALK gene analyses can be used to identify primary lesions in patients with cancers of unknown primary sites.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Watanabe
authors.forename: Tomoya
authors.initials: T
authors.lastname: Ishii
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takahama
authors.forename: Akira
authors.initials: A
authors.lastname: Tadokoro
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kanaji
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Dobashi
authors.forename: Shuji
authors.initials: S
authors.lastname: Bandoh
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000556:secondary*; D000077192:Adenocarcinoma of Lung; D000077548:Anaplastic Lymphoma Kinase; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology*; D005260:Female; D015971:Gene Expression Regulation, Enzymologic; D015972:Gene Expression Regulation, Neoplastic; D015321:Gene Rearrangement; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000556:secondary*; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D009333:Neck; D016609:Neoplasms, Second Primary / Q000473:pathology; D009382:Neoplasms, Unknown Primary / Q000473:pathology*; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases