Anaplastic lymphoma kinase-positive adenocarcinoma of lung:a cytopathologic analysis
10.3760/cma.j.issn.0529-5807.2015.09.004
- VernacularTitle:间变性淋巴瘤激酶阳性肺腺癌细胞病理学特点初探
- Author:
Ying CHEN
1
,
2
;
Lili GAO
;
YanLi WANG
;
Xian GUI
;
Hao ZHANG
;
Longfu WANG
;
Lianghong GU
;
Liqing FENG
;
Jiawen WU
;
Wentao YANG
;
Yiju SONG
;
Huan ZENG
;
Jing ZHANG
;
Qianming BAI
;
Xiaoyan ZHOU
;
Bo PING
Author Information
1. 200032 复旦大学附属肿瘤医院病理科
2. 复旦大学上海医学院肿瘤学系
- Keywords:
Lung neoplasms;
Adenocarcinoma;
Biopsy,needle;
In situ hybridization,fluorescence;
Cytodiagnosis
- From:
Chinese Journal of Pathology
2015;(9):628-632
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the cytomorphologic features of anaplastic lymphoma kinase ( ALK )-rearranged pulmonary adenocarcinoma.Methods The morphologic features in 153 pulmonary adenocarcinoma cytology specimens encountered during the period from September, 2011 to April, 2015 in Shanghai Cancer Hospital were retrospectively reviewed.Fluorescence in-situ hybridization ( FISH) and/or immunohistochemistry ( Ventana D5F3) for ALK gene rearrangement were carried out.The samples studied included 34 pleural effusion specimens, 40 endobronchial ultrasound-guided transbronchial needle aspirates ( EBUS-TBNA) and 79 fine needle aspirates of palpable masses on body surface.Results Thirty-nine cases (25.5%) of ALK-rearranged samples were identified by FISH and/or immunohistochemistry, including 3 cases diagnosed by FISH and 36 cases by both technologies.The median age of the ALK-positive group was 50 years, significantly younger than that of the ALK-negative group (60 years old,P=0.002) .Only 4 of the ALK-positive patients were smokers, which was significantly less than that of the ALK-negative group (P<0.01).In ALK-positive group, 3 cases showed cribriform pattern with prominent nucleoli, 3 cases showed cribriform pattern with mucin-rich cells and 8 cases showed extracellular mucus with mucin-rich cells.The above cytomorphologic patterns were significantly less common in ALK-negative tumors ( P <0.01 ) . Conclusions ALK-rearranged lung adenocarcinoma is associated with certain distinctive morphologic patterns, including cribriform architecture, presence of prominent nucleoli, mucin-rich cells and extracellular mucus, which can be observed in cytology specimens ( including conventional smears and cell block sections) .These findings, when combined with clinical features, may give clues to detection of ALK-positive cases.
