title: Different histopathology but the same clonality: ALK rearrangement in a patient with metastatic non-small-cell lung cancer.
abstract: EML4-ALK rearrangement is detected in 2% to 7% of lung adenocarcinomas, these tumors are sensitive to crizotinib. The histologic feature of ALK translocated non-small-cell lung cancer (NSCLC) has been studied, presence of signet-ring cells was a powerful histologic indicator of ALK rearrangement, and this characteristic histology was present both in primary sites and metastases. However, the case we discribed here has different histomorphology in primary sites and metastases, but has the same genotype which both present ALK rearrangement, while absent of EGFR mutation, KRAS mutation and ROS1 rearrangement. This histologic heterogeneity may be a supplement of the histologic feature of ALK rearranged tumor. Moreover, genomic analysis can help distinguish clonal tumors from independent primaries.
authors.affiliation: Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Jianya
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Xiuming
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Jianying
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Ding
mesh_terms: D000230:Adenocarcinoma / Q000201:enzymology / Q000235:genetics* / Q000556:secondary*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000235:genetics*; D001706:Biopsy; D002289:Carcinoma, Non-Small-Cell Lung / Q000201:enzymology / Q000235:genetics* / Q000556:secondary*; D004252:DNA Mutational Analysis; D066246:ErbB Receptors / Q000235:genetics; D015321:Gene Rearrangement; D020022:Genetic Predisposition to Disease; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000201:enzymology / Q000235:genetics* / Q000473:pathology*; D008297:Male; D009154:Mutation; D010641:Phenotype; D011237:Predictive Value of Tests; D011505:Protein-Tyrosine Kinases / Q000235:genetics; D011518:Proto-Oncogene Proteins / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; C512478:EGFR protein, human; D066246:ErbB Receptors; D011505:Protein-Tyrosine Kinases; C062333:ROS1 protein, human; D020794:Receptor Protein-Tyrosine Kinases; D016283:Proto-Oncogene Proteins p21(ras)
keywords: ALK rearrangement; Lung adenocarcinoma; histology; metastasis