Analysis of Histologic Features Suspecting Anaplastic Lymphoma Kinase (ALK)-Expressing Pulmonary Adenocarcinoma.
- Author:
In Ho CHOI
1
;
Dong Won KIM
;
Sang Yun HA
;
Yoon La CHOI
;
Hee Jeong LEE
;
Joungho HAN
Author Information
- Publication Type:Original Article
- Keywords: Lung; Adenocarcinoma; Anaplastic large cell lymphoma kinase; Anaplastic lymphoma kinase; in situ hybridization, fluorescence
- MeSH: Adenocarcinoma*; Carcinoma, Non-Small-Cell Lung; Complement System Proteins; Humans; Immunohistochemistry; In Situ Hybridization; In Situ Hybridization, Fluorescence; Intranuclear Inclusion Bodies; Lung; Lymphoma*; Mucins; Phosphotransferases*; Thyroid Neoplasms
- From:Journal of Pathology and Translational Medicine 2015;49(4):310-317
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Since 2007 when anaplastic lymphoma kinase (ALK) rearrangements were discovered in non-small cell lung cancer, the ALK gene has received attention due to ALK-targeted therapy, and a notable treatment advantage has been observed in patients harboring the EML4/ALK translocation. However, using ALK-fluorescence in situ hybridization (FISH) as the standard method has demerits such as high cost, a time-consuming process, dependency on interpretation skill, and tissue preparation. We analyzed the histologic findings which could complement the limitation of ALK-FISH test for pulmonary adenocarcinoma. METHODS: Two hundred five cases of ALK-positive and 101 of ALK-negative pulmonary adenocarcinoma from January 2007 to May 2013 were enrolled in this study. The histologic findings and ALK immunohistochemistry results were reviewed and compared with the results of ALK-FISH and EGFR/KRAS mutation status. RESULTS: Acinar, cribriform, and solid growth patterns, extracellular and intracellular mucin production, and presence of signet-ring-cell element, and psammoma body were significantly more often present in ALK-positive cancer. In addition, the presence of goblet cell-like cells and presence of nuclear inclusion and groove resembling papillary thyroid carcinoma were common in the ALK-positive group. CONCLUSIONS: The above histologic parameters can be helpful in predicting ALK rearranged pulmonary adenocarcinoma, leading to rapid FISH analysis and timely treatment.
