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Marghescu AȘ, Leonte DG, Radu AD, Măgheran ED, Tudor AV, Teleagă C, Țigău M, Georgescu L, Costache M. Atypical Histopathological Aspects of Common Types of Lung Cancer-Our Experience and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:112. [PMID: 38256374 PMCID: PMC10818882 DOI: 10.3390/medicina60010112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
Lung cancer is among the most common oncological diseases regarding incidence and mortality, with most of these having epithelial origins. Pathological reporting of these tumors is conducted according to the 5th edition of the World Health Organisation (WHO) classification of thoracic tumours. This study aims to draw the pathologist's attention to four rare, atypical microscopic aspects that some of the most common types of lung malignancies reveal upon standard evaluation (hematoxylin-eosin stain) that make histopathological diagnosis challenging: acantholytic, pseudoangiosarcomatous, signet ring cell, and clear cell features. Each of these aspects was exemplified by a case diagnosed in the pathology department of the "Marius Nasta" Institute. Furthermore, we analyzed the classification dynamics of different WHO editions and used PubMed to review articles written in English and published in the last eleven years on this subject. Pathologists should be familiar with these unusual aspects to avoid misdiagnoses and to ensure the correct classification of tumors, which is extremely important because these tumor phenotypes have been associated with specific molecular alterations and a worse clinical evolution. There is a need to clarify the histogenesis and associated genetic mutations, given the fact that the rarity of these tumor phenotypes makes their study difficult. Some authors consider these to be overlapping entities; however, we do not encourage this, as they may exhibit different prognoses and various molecular alterations with important therapeutic implications. The signet ring cell feature was associated with ALK rearrangement in lung adenocarcinoma; thus, these patients can benefit from tailored therapy with ALK-tyrosine kinase inhibitors (ALK-TKI). Recent studies associated clear cell morphology with FGFR3-TACC3 fusion, suggesting that patients with this diagnosis may be potentially eligible for FGFR inhibitors. We described, for the first time, the pseudoangiosarcomatous pattern in a case of lung adenocarcinoma; to our knowledge this aspect has only been described until now in the context of squamous cell carcinomas.
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Affiliation(s)
- Angela-Ștefania Marghescu
- Research Department, “Marius Nasta” Institute of Pneumophthisiology, 050159 Bucharest, Romania; (A.D.R.); (C.T.); (M.Ț.); (L.G.)
- Pathology Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Diana Gabriela Leonte
- Pathology Department, “Marius Nasta” Institute of Pneumophthisiology, 050159 Bucharest, Romania; (D.G.L.); (E.D.M.); (A.V.T.)
| | - Alexandru Daniel Radu
- Research Department, “Marius Nasta” Institute of Pneumophthisiology, 050159 Bucharest, Romania; (A.D.R.); (C.T.); (M.Ț.); (L.G.)
| | - Elena Doina Măgheran
- Pathology Department, “Marius Nasta” Institute of Pneumophthisiology, 050159 Bucharest, Romania; (D.G.L.); (E.D.M.); (A.V.T.)
| | - Adrian Vasilică Tudor
- Pathology Department, “Marius Nasta” Institute of Pneumophthisiology, 050159 Bucharest, Romania; (D.G.L.); (E.D.M.); (A.V.T.)
| | - Cristina Teleagă
- Research Department, “Marius Nasta” Institute of Pneumophthisiology, 050159 Bucharest, Romania; (A.D.R.); (C.T.); (M.Ț.); (L.G.)
| | - Mirela Țigău
- Research Department, “Marius Nasta” Institute of Pneumophthisiology, 050159 Bucharest, Romania; (A.D.R.); (C.T.); (M.Ț.); (L.G.)
| | - Livia Georgescu
- Research Department, “Marius Nasta” Institute of Pneumophthisiology, 050159 Bucharest, Romania; (A.D.R.); (C.T.); (M.Ț.); (L.G.)
| | - Mariana Costache
- Pathology Department, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Pathology Department, University Emergency Hospital, 050098 Bucharest, Romania
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2
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Tan Y, Huang YH, Xue JW, Zhang R, Liu R, Wang Y, Feng ZB. Clinicopathological features and prognostic significance of pulmonary adenocarcinoma with signet ring cell components: meta-analysis and SEER analysis. Clin Exp Med 2023; 23:4341-4354. [PMID: 37779169 DOI: 10.1007/s10238-023-01200-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023]
Abstract
Pulmonary adenocarcinoma is a common type of lung cancer that has been on the rise in recent years. Signet ring cell components (SRCC) can be present in various patterns of pulmonary adenocarcinoma, including papillary, acinar, and solid patterns. "Signet ring cell carcinoma" is a distinct subtype in the 2014 WHO classification of lung neoplasms, subsequent WHO classifications in 2015 and 2021 have deemed signet ring cells as accompanying morphological features with no clinical significance. The prognostic and clinical implications of SRCC in pulmonary adenocarcinoma remain controversial. Therefore, we conducted a meta-analysis to investigate the clinicopathological features and prognostic factors of SRCC in pulmonary adenocarcinoma. We conducted a comprehensive search in PubMed, EMBASE, and Web of Science to identify studies that examined the clinicopathological features and prognostic implications of pulmonary adenocarcinoma with SRCC. We used both fixed- and random-effects models to analyze the data and calculate the pooled hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (CIs). Additionally, we explored the prognostic significance of SRCC in pulmonary adenocarcinoma using the Surveillance, Epidemiology, and End Results (SEER) database. Our meta-analysis included 29 studies with pulmonary adenocarcinoma and SRCC components. The results showed that pulmonary adenocarcinoma with SRCC was associated with larger tumor size (OR = 1.99; 95% CI, 1.62-2.44, p < 0.001), advanced overall stage (OR = 5.18, 95% CI, 3.28-8.17, p < 0.00001) and lymph node stage (OR = 5.79, 95% CI, 1.96-17.09, p = 0.001), and worse overall survival (OS) compared to those without SRCC (HR = 1.80, 95% CI, 1.50-2.16, p < 0.00001). Analysis using the SEER dataset confirmed these findings. Our meta-analysis provides evidence that pulmonary adenocarcinoma with SRCC is associated with distinct clinicopathological features and a poorer prognosis. These findings have important implications for the management and treatment of patients. However, further studies are needed to validate these findings and explore the significance of SRCC in various subtypes of pulmonary adenocarcinoma.
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Affiliation(s)
- Yang Tan
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Ying-He Huang
- Department of Pathology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Jia-Wen Xue
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Rui Zhang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Run Liu
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Yan Wang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Zhen-Bo Feng
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No.6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China.
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Shaker N, Shaker N, Abid A, Tynski IM, Tynski Z, Parwani A. Cytomorphological features of ALK-positive pulmonary adenocarcinoma with abundant psammoma bodies. Diagn Cytopathol 2023; 51:712-715. [PMID: 37534826 DOI: 10.1002/dc.25208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Nuha Shaker
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Abdul Abid
- Department of Pathology, University of Virginia Health, Charlottesville, Virginia, USA
| | | | - Zofia Tynski
- Department of Pathology, Fairfield Medical Center, Lancaster, Ohio, USA
| | - Anil Parwani
- Anatomic Pathology, Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Okazaki T, Iwasaki Y, Kubo Y, Kodama K, Nakatsuka SI. Anaplastic Lymphoma Kinase (ALK)-Rearranged Lung Cancer That Showed Exclusively Scattered Isolated Cells Devoid of Mucin Production in Cytology. Cureus 2023; 15:e46339. [PMID: 37920641 PMCID: PMC10618568 DOI: 10.7759/cureus.46339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/04/2023] Open
Abstract
We present a rare case of Anaplastic Lymphoma Kinase (ALK)-rearranged lung cancer characterized by isolated scattered mucin-free cancer cells forming no clusters in the cytology of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples from a paratracheal lymph node. A female patient in her late 40s underwent chest and abdominal CT scan, revealing a 6 cm diameter tumor in the upper lobe of the left lung along with enlargement of mediastinal and hilar lymph nodes, bilateral pleural effusion, and an additional 5.5 cm diameter tumor in the right greater psoas muscle. EBUS-TBNA was performed to obtain samples for cytological and histological examination. Cytology showed exclusively solitary cancer cells that were negative for Periodic Acid-Schiff (PAS) and Alcian blue staining, without clusters. Immunohistochemical analysis of cell block and histology specimens demonstrated positive expression of TTF-1, ALK, and vimentin, while E-cadherin expression was absent. Genetic analysis of samples obtained by EBUS-TBNA confirmed the presence of EML4-ALK fusion. The tumor in the right greater psoas muscle was identified as a metastatic tumor from the lung tumor based on ALK-positivity and the EML4-ALK fusion. The absence of E-cadherin expression and the presence of vimentin expression suggest that this ALK-rearranged lung cancer may have undergone epithelial-mesenchymal transition, resulting in the loss of cellular adhesiveness.
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Affiliation(s)
- Tsuyoshi Okazaki
- Department of Clinical Laboratory, Yao Tokushukai General Hospital, Yao, JPN
| | - Yoshie Iwasaki
- Department of Clinical Laboratory, Yao Tokushukai General Hospital, Yao, JPN
| | - Yuki Kubo
- Department of Pathology, Yao Tokushukai General Hospital, Yao, JPN
| | - Ken Kodama
- Department of Thoracic Surgery, Yao Municipal Hospital, Yao, JPN
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Ishii S, Takamatsu M, Ninomiya H, Inamura K, Horai T, Iyoda A, Honma N, Hoshi R, Sugiyama Y, Yanagitani N, Mun M, Abe H, Mikami T, Takeuchi K. Machine learning-based gene alteration prediction model for primary lung cancer using cytologic images. Cancer Cytopathol 2022; 130:812-823. [PMID: 35723561 DOI: 10.1002/cncy.22609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/28/2022] [Accepted: 05/23/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Understanding the gene alteration status of primary lung cancers is important for determining treatment strategies, but gene testing is both time-consuming and costly, limiting its application in clinical practice. Here, potential therapeutic targets were selected by predicting gene alterations in cytologic specimens before conventional gene testing. METHODS This was a retrospective study to develop a cytologic image-based gene alteration prediction model for primary lung cancer. Photomicroscopic images of cytology samples were collected and image patches were generated for analyses. Cancer-positive (n = 106) and cancer-negative (n = 32) samples were used to develop a neural network model for selecting cancer-positive images. Cancer-positive cases were randomly assigned to training (n = 77) and validation (n = 26) data sets. Another neural network model was developed to classify cancer images of the training data set into 4 groups: anaplastic lymphoma kinase (ALK)-fusion, epidermal growth factor receptor (EGFR), or Kirsten rat sarcoma viral oncogene homologue (KRAS) mutated groups, and other (None group), and images of the validation data set were classified. A decision algorithm to predict gene alteration for cases with 3 probability ranks was developed. RESULTS The accuracy and precision for selecting cancer-positive patches were 0.945 and 0.991, respectively. Predictive accuracy for the EGFR and KRAS groups in the validation data set was ~0.95, whereas that for the ALK and None groups was ~0.75 and ~ 0.80, respectively. Gene status was correctly predicted in the probability rank A cases. The model extracted characteristic conventional cytologic findings in images and a novel specific feature was discovered for the EGFR group. CONCLUSIONS A gene alteration prediction model for lung cancers by machine learning based on cytologic images was successfully developed.
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Affiliation(s)
- Shuhei Ishii
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Pathology, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Manabu Takamatsu
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hironori Ninomiya
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kentaro Inamura
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Horai
- Department of Thoracic Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akira Iyoda
- Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Naoko Honma
- Department of Pathology, Toho University School of Medicine, Tokyo, Japan
| | - Rira Hoshi
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuko Sugiyama
- Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Noriko Yanagitani
- Department of Thoracic Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mingyon Mun
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hitoshi Abe
- Department of Cytology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tetuo Mikami
- Department of Pathology, Toho University School of Medicine, Tokyo, Japan
| | - Kengo Takeuchi
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
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6
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Canterbury CR, Fernandes H, Crapanzano JP, Murty VV, Mansukhani MM, Shu CA, Szabolcs M, Saqi A. ALK Gene Rearrangements in Lung Adenocarcinomas: Concordance of Immunohistochemistry, Fluorescence In Situ Hybridization, RNA In Situ Hybridization, and RNA Next-Generation Sequencing Testing. JTO Clin Res Rep 2021; 2:100223. [PMID: 34746883 PMCID: PMC8552107 DOI: 10.1016/j.jtocrr.2021.100223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/05/2021] [Accepted: 08/29/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction The 2018 updated molecular testing guidelines for patients with advanced lung cancer incorporated ALK immunohistochemistry (IHC) analysis as an equivalent to fluorescence in situ hybridization (FISH) method recommended in 2013. Nevertheless, no specific recommendation for alternative methods was proposed owing to insufficient data. The aim of this study was to compare the results of ALK IHC, FISH, RNA next-generation sequencing (NGS), and RNA in situ hybridization (ISH) with available clinical data. Methods A search for lung carcinomas with ALK testing by greater than or equal to one modality (i.e., ALK IHC, FISH, NGS) was performed; a subset underwent RNA ISH. When available, clinical data were recorded. Results The results were concordant among all performed testing modalities in 86 of 90 cases (95.6%). Of the four discordant cases, two were ALK positive by FISH but negative by IHC, RNA NGS, and RNA ISH. The remaining two cases failed RNA NGS testing, one was IHC negative, FISH positive, RNA ISH negative and the second was IHC positive, FISH positive, RNA ISH equivocal. RNA NGS identified one rare and one novel ALK fusion. Sufficient therapy data were available in 10 cases treated with tyrosine kinase inhibitors; three had disease progression, including one with discordant results (FISH positive, RNA NGS negative, IHC negative, RNA ISH negative) and two with concordant ALK positivity among all modalities. Conclusions Our results reveal high concordance among IHC, RNA NGS, and RNA ISH. In cases of discordance with available RNA NGS, FISH result was positive whereas IHC and ISH results were negative. On the basis of our data, multimodality testing is recommended to identify discrepant results and patients (un)likely to respond to tyrosine kinase inhibitors.
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Affiliation(s)
- Carleigh R Canterbury
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - Helen Fernandes
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - John P Crapanzano
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - Vundavalli V Murty
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - Mahesh M Mansukhani
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - Catherine A Shu
- Division of Hematology/Oncology, Department of Medicine, Columbia University Medical Center, New York, New York
| | - Matthias Szabolcs
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - Anjali Saqi
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
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7
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Watanabe F, Adachi K, Ito K, Iwanaka S, Ohiwa A, Sakakura Y, Nishimura T, Naito M. Extensive calcification in adenocarcinoma of the lung: A case report. Thorac Cancer 2020; 11:3038-3042. [PMID: 32869499 PMCID: PMC7529567 DOI: 10.1111/1759-7714.13637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/08/2020] [Accepted: 08/09/2020] [Indexed: 11/27/2022] Open
Abstract
Calcification in lung nodules usually indicates a benign lesion. Here, we report the case of a 59‐year‐old male patient with a well defined 30 mm calcified nodule in his right upper lung lobe and calcified mediastinal lymph nodes. The mass was diagnosed as adenocarcinoma by transbronchial biopsy. He received systemic chemotherapy, followed by lobectomy and mediastinal lymph node dissection. During surgery, the lymph nodes were tightly adherent to the superior vena cava with invasion of the vascular wall. Pathological diagnosis confirmed acinar adenocarcinoma and psammoma bodies (PBs). Immunohistochemical analysis revealed tumor cells positive for parathyroid hormone‐related proteins 1 and 2. Calcification of primary lung adenocarcinoma is rare. We report a calcified lesion where the secretion of parathyroid hormone by the tumor may have caused the accumulation of PBs. Calcification of metastatic lymph nodes may increase the risk of adhesion, requiring care during surgery. Key points Significant findings of the studyLung adenocarcinoma with extensive calcification in primary and metastatic lymph node lesions is rare and the mechanism involved is poorly understood. Of significance, calcification in our case was related to parathyroid hormone‐related proteins 1 and 2 secreted by the tumor.
What this study addsThis study suggests the potential role of parathyroid hormone‐related proteins in lung tumor calcification. The implications for clinicians are that calcified metastatic lymph nodes and tumors might be tightly fused to tissues. Therefore, surgery should be conducted with care.
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Affiliation(s)
- Fumiaki Watanabe
- Department of Thoracic Surgery, Mie Chuo Medical Center, Tsu City, Japan
| | - Katsutoshi Adachi
- Department of Thoracic Surgery, Mie Chuo Medical Center, Tsu City, Japan
| | - Kentaro Ito
- Department of Respiratory Medicine, Matsusaka City Hospital, Matsusaka City, Japan
| | - Soichi Iwanaka
- Department of Respiratory Medicine, Mie Chuo Medical Center, Tsu City, Japan
| | - Ayaka Ohiwa
- Department of Respiratory Medicine, Mie Chuo Medical Center, Tsu City, Japan
| | - Yasumasa Sakakura
- Department of Respiratory Medicine, Mie Chuo Medical Center, Tsu City, Japan
| | - Tadashi Nishimura
- Department of Respiratory Medicine, Mie Chuo Medical Center, Tsu City, Japan
| | - Masahiro Naito
- Department of Respiratory Medicine, Mie Chuo Medical Center, Tsu City, Japan
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Pagan C, Barua S, Hsiao SJ, Mansukhani M, Saqi A, Murty V, Fernandes H. Targeting SLMAP-ALK-a novel gene fusion in lung adenocarcinoma. Cold Spring Harb Mol Case Stud 2019; 5:mcs.a003939. [PMID: 31160357 PMCID: PMC6549559 DOI: 10.1101/mcs.a003939] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/08/2019] [Indexed: 11/24/2022] Open
Abstract
Assessment of ALK gene rearrangements is strongly recommended by the Molecular Testing Guideline for Selection of Lung Cancer Patients proposed by IASLC, AMP, and CAP at the time of diagnosis for patients with advanced stage disease. Non-small-cell lung cancer (NSCLC) with ALK gene rearrangements or the resulting fusion proteins have been, for the most part, successfully targeted with ALK tyrosine kinase inhibitors (TKIs). The most frequent rearrangement, the EML4-ALK oncogenic fusion, has more than 10 distinct variants, each with a discrete breakpoint in EML4. Recent studies have suggested that EML4-ALK variants may have differential responses to TKIs. Additionally, non-EML4-ALK fusions that result from ALK rearrangements with diverse 5′ partners could possibly have varied biologic and clinical implications in their therapeutic responses and outcomes of patients with NSCLC. Existing literature documents at least 20 non-EML4 fusion partners for ALK, and the clinical responsiveness to crizotinib ranges from increased sensitivity to resistance. This underscores the importance of identifying the precise 5′ fusion partner to ALK before initiation of therapy. Herein we report the identification of a novel SLMAP-ALK fusion in a patient with NSCLC.
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Affiliation(s)
- Carlos Pagan
- Laboratory of Personalized Genomic Medicine, Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York 10032, USA
| | - Subit Barua
- Laboratory of Personalized Genomic Medicine, Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York 10032, USA
| | - Susan J Hsiao
- Laboratory of Personalized Genomic Medicine, Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York 10032, USA
| | - Mahesh Mansukhani
- Laboratory of Personalized Genomic Medicine, Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York 10032, USA
| | - Anjali Saqi
- Laboratory of Personalized Genomic Medicine, Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York 10032, USA
| | - Vundavalli Murty
- Laboratory of Personalized Genomic Medicine, Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York 10032, USA
| | - Helen Fernandes
- Laboratory of Personalized Genomic Medicine, Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York 10032, USA
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Shukla S, Husain N, Gupta A, Anand N. Cytomorphological Features of Lung Adenocarcinoma with Anaplastic Lymphoma Kinase Gene Rearrangement. J Cytol 2019; 36:8-12. [PMID: 30745732 PMCID: PMC6343393 DOI: 10.4103/joc.joc_127_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: The anaplastic lymphoma kinase (ALK) gene rearrangement is a predictive and prognostic marker in pulmonary adenocarcinoma. A series of clinical and pathological features have been documented in patients who harbor this translocation. Aims: The objectives of this study were to analyze the specific cytomorphological features of lung adenocarcinoma that harbored the ALK gene rearrangement and to compare the morphological features with the mutation-negative cases. Materials and Methods: The study sample of 40 cases included 15 ALK-positive cases and 25 ALK-negative cases. After the diagnosis was established, testing for ALK rearrangement was on the histopathology sample. The corresponding fine-needle aspiration cytology slides were retrieved from the records and cytomorphological features were analyzed. Results: A comparison of pattern between the ALK-positive and ALK-negative group revealed that the sheet-like pattern and singly scattered cells were more common in the ALK-positive group. Moderate-to-severe nuclear pleomorphism was identified in 80% of ALK-positive cases and 72% of ALK-negative cases. The presence of mucinous features and/or signet ring morphology was the most striking feature of ALK-positive cases with P value of 0.002. The presence of necrosis in the background was identified in 80% of ALK-positive cases and was statistically significant (P = 0.001). Conclusion: This is among the few studies from India, where a detailed analysis of the cytomorphological features of cases with ALK phenotype versus the mutation negative cases has been performed.
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Affiliation(s)
- Saumya Shukla
- Department of Pathology, Dr. Ram Manohar Lohia, Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nuzhat Husain
- Department of Pathology, Dr. Ram Manohar Lohia, Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anurag Gupta
- Department of Pathology, Dr. Ram Manohar Lohia, Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nidhi Anand
- Department of Pathology, Dr. Ram Manohar Lohia, Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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10
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Tsukamoto R, Ohsaki H, Hosokawa S, Tokuhara Y, Kamoshida S, Sakuma T, Itoh T, Ohbayashi C. Qualitative and quantitative cytomorphological features of primary anaplastic lymphoma kinase-positive lung cancer. Cytopathology 2018; 30:295-300. [PMID: 30506595 DOI: 10.1111/cyt.12667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/20/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Anaplastic lymphoma kinase (ALK) positive (+) lung cancers are predictive for response to crizotinib and alectinib. There are many cases of lung cancer in which surgery cannot be performed, and such cases require diagnosis by cytological specimen or biopsy. Estimating ALK (+) lung cancer from cytomorphology would allow molecular testing to proceed without the waste of a small amount of specimen. The purpose of this study was to assess whether qualitative and quantitative cytomorphological features are sufficient for distinguishing primary ALK (+) from ALK (-) lung cancer. METHODS We examined eight qualitative cytomorphological parameters and three quantitative nuclear morphometric parameters in 17 cases of primary ALK (+) lung cancer, diagnosed by fluorescence in situ hybridisation (FISH) using histological specimens, and in 41 cases of ALK (-) lung cancer. Quantitative nuclear morphometric parameters were analysed by a computer-assisted image analysis system. RESULTS In ALK (+) lung cancer, three qualitative parameters (signet ring cells, nuclear grooves and single type nucleoli) and two quantitative parameters (large nuclear area and irregular nuclear shape) were observed in significantly higher proportions. However, in ALK (-) lung cancer, one qualitative parameter (unclear and multiple type nucleoli) was seen significantly more often. CONCLUSIONS These results show that the cytomorphological features of signet ring cells, nuclear grooves and nucleoli shape can help to triage a small amount of cytological and biopsy specimens for appropriate molecular testing of primary ALK (+) lung cancer.
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Affiliation(s)
- Ryuko Tsukamoto
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyuki Ohsaki
- Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Sho Hosokawa
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan
| | - Yasunori Tokuhara
- Department of Medical Technology, Ehime Prefectural University of Health Sciences, Ehime, Japan
| | - Shingo Kamoshida
- Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Toshiko Sakuma
- Department of Pathology, Hyogo Cancer Center, Hyogo, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chiho Ohbayashi
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
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11
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Non-small cell lung carcinoma: molecular genetics with consideration of cytologic samples. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.mpdhp.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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12
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Zhao J, Zheng J, Kong M, Zhou J, Ding W, Zhou J. Advanced lung adenocarcinomas with ROS1-rearrangement frequently show hepatoid cell. Oncotarget 2018; 7:74162-74170. [PMID: 27708233 PMCID: PMC5342043 DOI: 10.18632/oncotarget.12364] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 09/16/2016] [Indexed: 01/15/2023] Open
Abstract
Defining distinctive histologic characteristics of ROS1-rearranged non-small-cell lung carcinomas (NSCLCs) may help identify cases that merit molecular testing. However, the majority of previous reports have focused on surgical specimens but only limited studies assessed histomorphology of advanced NSCLCs. In order to identify the clinical and histological characteristics of ROS1-rearranged advanced NSCLCs, we examined five hundred sixteen Chinese patients with advanced NSCLCs using ROS1 fluorescence in situ hybridization and real-time polymerase chain reaction and then analyzed for clinical and pathological features. We performed univariate and multivariate analyses to identify predictive factors associated with ROS1 rearrangement. 19 tumors were identified with ROS1 rearrangement (3.7% of adenocarcinomas). 16 ROS1+ and 122 ROS1- samples with available medical records and enough tumor cells were included for histological analysis. Compared with ROS1-negative advanced NSCLCs, ROS1-rearranged advanced NSCLCs were associated with a younger age at presentation. ROS1 rearrangements were not significantly associated with sex, smoking history, drinking history and metastatic sites. The most common histological pattern was solid growth (12/16), followed by acinar (4/16) growth. 66.7% cases with solid growth pattern showed hepatoid cytology (8/12) and 75% cases with acinar growth pattern showed a cribriform structure (3/4). 18.8% cases were found to have abundant extracellular mucus or signet-ring cells (3/16). Only one case with solid growth pattern showed psammomatous calcifications. In conclusion, age, hepatoid cytology and cribriform structure are the independent predictors for ROS1-rearranged advanced NSCLCs, recognizing these may be helpful in finding candidates for genomic alterations, especially when available tissue samples are limited.
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Affiliation(s)
- Jing Zhao
- Department of Pathology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jing Zheng
- Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Mei Kong
- Department of Pathology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jianya Zhou
- Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Ding
- Department of Pathology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jianying Zhou
- Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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13
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Kuroda N, Ohara M, Wada Y, Yasuoka K, Mizuno K, Yorita K, Obayashi C, Takeuchi K. Cytological features in eight patients with ALK-rearranged lung cancer. Diagn Cytopathol 2017; 46:516-519. [PMID: 29280331 DOI: 10.1002/dc.23879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 10/14/2017] [Accepted: 12/11/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND ALK-rearranged lung cancer has been recently identified. Although signet-ring cell morphology and mucinous cribriform pattern are considered to be characteristic of ALK-rearranged lung cancer. Some studies have also suggested cytological features. METHODS This study investigated cytological features of ALK-rearranged lung cancer in eight patients. RESULTS Cytologically, the tumor cell group varied from isolated to large clusters. Small nucleoli, fine granular to vesicular chromatin, and nuclear groove were observed in all patients. Furthermore, extracellular and intracellular mucin and signet-ring cells were identified in five patients. CONCLUSION This study demonstrated that the presence of extracellular and intracellular mucin, signet-ring cells, small nucleoli, fine granular to vesicular chromatin, and nuclear groove in cytological samples may be a diagnostic clue for ALK-rearranged lung cancer.
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Affiliation(s)
- Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan
| | - Masahiko Ohara
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan
| | - Yukari Wada
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan
| | - Kaori Yasuoka
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan
| | - Keiko Mizuno
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan
| | - Kenji Yorita
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan
| | - Chiho Obayashi
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, the Cancer Institute, Japanese Foundation of Cancer Research, Tokyo, Japan
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14
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Miyake A, Okudela K, Matsumura M, Hideaki M, Arai H, Umeda S, Yamanaka S, Ishikawa Y, Tajiri M, Ohashi K. Update on the potential significance of psammoma bodies in lung adenocarcinoma from a modern perspective. Histopathology 2017; 72:609-618. [DOI: 10.1111/his.13397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/06/2017] [Accepted: 09/08/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Akio Miyake
- Division of Diagnostic Pathology; Yokohama City University Hospital; Yokohama Japan
| | - Koji Okudela
- Department of Pathology; Yokohama University Graduate School of Medicine; Yokohama Japan
| | - Mai Matsumura
- Division of Diagnostic Pathology; Yokohama City University Hospital; Yokohama Japan
| | - Mitsui Hideaki
- Department of Pathology; Yokohama University Graduate School of Medicine; Yokohama Japan
| | - Hiromasa Arai
- Division of General Thoracic Surgery; Kanagawa Prefectural Cardiovascular and, Respiratory Centre Hospital; Yokohama Japan
| | - Shigeaki Umeda
- Department of Pathology; Yokohama University Graduate School of Medicine; Yokohama Japan
| | - Shoji Yamanaka
- Division of Diagnostic Pathology; Yokohama City University Hospital; Yokohama Japan
| | - Yoshihiro Ishikawa
- Division of General Thoracic Surgery; Yokohama City University Hospital; Yokohama Japan
| | - Michihiko Tajiri
- Division of General Thoracic Surgery; Kanagawa Prefectural Cardiovascular and, Respiratory Centre Hospital; Yokohama Japan
| | - Kenichi Ohashi
- Division of Diagnostic Pathology; Yokohama City University Hospital; Yokohama Japan
- Department of Pathology; Yokohama University Graduate School of Medicine; Yokohama Japan
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15
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Miyata K, Morita S, Dejima H, Seki N, Matsutani N, Mieno M, Kondo F, Soejima Y, Tanaka F, Sawabe M. Cytological markers for predicting ALK-positive pulmonary adenocarcinoma. Diagn Cytopathol 2017; 45:963-970. [PMID: 28834601 DOI: 10.1002/dc.23800] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/03/2017] [Accepted: 08/09/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND ALK gene rearrangement is an important class of gene mutations in pulmonary adenocarcinoma. ALK-positive pulmonary adenocarcinoma exhibits characteristic histological features, such as signet ring cell carcinoma (SRCC) and a mucinous cribriform structure. However, when insufficient histological specimens are obtained, ALK-positivity must be predicted based on cytological features. The purpose of this study was to clarify the cytological characteristics of ALK-positive pulmonary adenocarcinoma. METHODS We compared the cytological findings of 16 ALK-positive cases with 40 ALK-negative cases. We examined various cytoplasmic features of SRCC, including the presence of pink, yellow, or orange mucin; green, vacuolar, or vesicular cytoplasm; and green globular cytoplasmic secretions. We also examined whether the SRCC cells exhibited a pattern of individually scattered cells, the formation of cell clusters, and formation of a mucinous cribriform pattern. RESULTS A univariate analysis showed that significantly frequent cytological findings included pink mucin, green cytoplasm, vacuolar cytoplasm, vesicular cytoplasm, green globular cytoplasmic secretions, an individually scattered pattern, cluster formation, and a mucinous cribriform structure (all, P < .05). A stepwise multivariate logistic regression analysis identified three significant contributing factors: pink mucin (P = .03), vesicular cytoplasm (P = .06), and an individually scattered pattern (P = .01) of SRCC. If the specimens showed two or three of these features, the sensitivity and specificity were both 88% for the prediction of ALK-positive cancers. CONCLUSION Three cytological features of SRCC (pink mucin, vesicular cytoplasm, and an individually scattered pattern) could be useful cytological markers for the prediction of ALK-positive pulmonary adenocarcinoma.
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Affiliation(s)
- K Miyata
- Department of Pathology, Teikyo University Hospital, Tokyo, Japan.,Department of Molecular Pathology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - S Morita
- Department of Pathology, Teikyo University Hospital, Tokyo, Japan.,Department of Pathology, Tokyo University Hospital, Tokyo, Japan
| | - H Dejima
- Department of Surgery, Teikyo University Hospital, Tokyo, Japan
| | - N Seki
- Department of Medical Oncology, Teikyo University Hospital, Tokyo, Japan
| | - N Matsutani
- Department of Surgery, Teikyo University Hospital, Tokyo, Japan
| | - M Mieno
- Center for Information, Jichi Medical University, Tochigi, Japan
| | - F Kondo
- Department of Pathology, Teikyo University Hospital, Tokyo, Japan
| | - Y Soejima
- Department of Molecular Pathology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - F Tanaka
- Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - M Sawabe
- Department of Molecular Pathology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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16
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DiBardino DM, Rawson DW, Saqi A, Heymann JJ, Pagan CA, Bulman WA. Next-generation sequencing of non-small cell lung cancer using a customized, targeted sequencing panel: Emphasis on small biopsy and cytology. Cytojournal 2017; 14:7. [PMID: 28413430 PMCID: PMC5379858 DOI: 10.4103/1742-6413.202602] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 09/08/2016] [Indexed: 02/02/2023] Open
Abstract
Background: Next-generation sequencing (NGS) with a multi-gene panel is now available for patients with lung adenocarcinoma, but the performance characteristics and clinical utility of this testing are not well-described. We present the results of an extended 467 gene panel in a series of advanced, highly selected nonsmall cell lung cancer (NSCLC) patients using a range of specimens, including predominantly small biopsy and cytology specimens. Materials and Methods: A retrospective review of 22 NSCLC biopsies sent for NGS using an extended gene panel from January 2014 to July 2015. The customized NGS panel sequences 467 cancer-associated genes with exonic and intronic sequences obtained from purified tumor DNA. Genomic alterations, patient characteristics, and success of testing were determined. Results: The majority of samples tested were metastatic lung adenocarcinoma on final pathology. Of the 22 specimens tested, 5 (22.7%) were surgical resections and 17 (77.3%) were small biopsy and cytology specimens. Twenty-one (95%) of the specimens were adequate for full sequencing and yielded a total of 204 genomic alterations (average 8.9 per tumor), of which 17 (average 0.81 per tumor) were actionable and/or clinically relevant. Genomic alterations were found most commonly in the TP53, EGFR, EPHB1, MLL3, APC, SETD2, KRAS, DNMT3A, RB1, CDKN2A, ARID1A, EP300, KDM6B, RAD50, STK11, and BRCA2 genes. Conclusions: NGS using a comprehensive gene panel was performed successfully in 95% of all NSCLC cases in this series, including 94% small biopsy and cytology specimens and 100% surgical resections. This custom assay was performed on a range of tumor specimens and demonstrates that small specimens are able to provide a similar depth of information as larger ones. As many patients present at an advanced stage and only small specimens are obtained, the information these provide has the potential for guiding treatment in highly selected patients with advanced lung adenocarcinoma.
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Affiliation(s)
- David M DiBardino
- Address: Division of Pulmonology, Allergy, Immunology and Critical Care, Section of Interventional Pulmonology, University of Pennsylvania, Philadelphia, PA, USA
| | - David W Rawson
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Anjali Saqi
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Jonas J Heymann
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Carlos A Pagan
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - William A Bulman
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
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17
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Bal A, Singh N, Agarwal P, Das A, Behera D. ALK gene rearranged lung adenocarcinomas: molecular genetics and morphology in cohort of patients from North India. APMIS 2016; 124:832-8. [PMID: 27500967 DOI: 10.1111/apm.12581] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/19/2016] [Indexed: 12/15/2022]
Abstract
ALK gene rearrangement in the lung adenocarcinomas is the second most common (1.6-11.7% of NSCLC) targetable genomic change after EGFR mutations. However, the prevalence and clinicopathological features of ALK-rearranged lung adenocarcinomas from North India are lacking. A total of 240 cases of lung adenocarcinoma were screened for EGFR mutations and for ALK expression. Smoking status, TNM stage, and treatment response were recorded in all cases. Out of 240 cases screened, 37 cases were positive for EGFR mutations and 17 cases (7.08%) showed ALK positivity with immunohistochemistry and break-apart FISH. On excluding 37 EGFR mutation-positive cases, the incidence of ALK-positive adenocarcinoma appears to be higher (17/203 cases, 8.03%). Eight were men and nine were women with mean age of 51.7 years. Majority (62.5%) were non-smokers and had unresectable disease (70.6% stage IV, 17.6% IIIB). The morphological patterns noted were solid (12 cases), papillary (four cases), and micropapillary (one case). Signet ring (two cases) and clear cell change (one cases) were noted. Out of five patients who received crizotinib, three had partial response and two had stable disease. ALK-rearranged lung adenocarcinomas account for a minor proportion of NSCLC with prevalence similar to that reported in literature. However, as contrast to published data in our series, patients were in older age group and had solid and papillary pattern on morphology with an aggressive course.
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Affiliation(s)
- Amanjit Bal
- Department of Histopathology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
| | - Navneet Singh
- Department of Pulmonary Medicine, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Parimal Agarwal
- Department of Histopathology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Ashim Das
- Department of Histopathology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Digambar Behera
- Department of Pulmonary Medicine, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
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18
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Viola P, Maurya M, Croud J, Gazdova J, Suleman N, Lim E, Newsom-Davis T, Plowman N, Rice A, Montero MA, Gonzalez de Castro D, Popat S, Nicholson AG. A Validation Study for the Use of ROS1 Immunohistochemical Staining in Screening for ROS1 Translocations in Lung Cancer. J Thorac Oncol 2016; 11:1029-39. [DOI: 10.1016/j.jtho.2016.03.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/17/2016] [Accepted: 03/31/2016] [Indexed: 12/21/2022]
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19
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Yu Y, Ding Z, Zhu L, Teng H, Lu S. Frequencies of ALK rearrangements in lung adenocarcinoma subtypes: a study of 2299 Chinese cases. SPRINGERPLUS 2016; 5:894. [PMID: 27386342 PMCID: PMC4923004 DOI: 10.1186/s40064-016-2607-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/16/2016] [Indexed: 01/06/2023]
Abstract
Purpose This study aimed to determine the relationship between ALK status and lung adenocarcinoma subtypes, according to the IALSC/ATS/ERS classification in Chinese patients. Methods A reclassification of 2299 surgically resected lung adenocarcinomas was performed, and ALK status was detected by immunohistochemistry (Ventana Medical Systems) in Shanghai Chest Hospital. Results ALK rearrangements were identified in 93 of 2299 tumors (4.0 %). The ALK rearrangements frequencies were: 14.8 % (16/108), 10.3 % (20/195), 7.6 % (13/170), 2.8 % (29/1035), 2.5 % (3/119), 2.0 % (11/539), 0.9 % (1/114), and 0 % (0/19) for variants of invasive adenocarcinoma, solid predominant, micropapillary predominant, acinar predominant, minimally invasive adenocarcinoma, papillary predominant, lepidic predominant, and adenocarcinoma in situ, respectively. Conclusions We reported significant discrepancies of ALK status in lung adenocarcinoma subtypes in Chinese patients. Electronic supplementary material The online version of this article (doi:10.1186/s40064-016-2607-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yongfeng Yu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Xuhui District, Shanghai, 200030 China
| | - Zhengping Ding
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Xuhui District, Shanghai, 200030 China
| | - Lei Zhu
- Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Xuhui District, Shanghai, 200030 China
| | - Haohua Teng
- Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Xuhui District, Shanghai, 200030 China
| | - Shun Lu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Xuhui District, Shanghai, 200030 China
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20
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Leiman G. Two decades of lung cancer through the pages of Cancer Cytopathology. Cancer Cytopathol 2016; 124:375-9. [PMID: 27294407 DOI: 10.1002/cncy.21737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Gladwyn Leiman
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, Vermont
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21
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DiBardino DM, Saqi A, Elvin JA, Greenbowe J, Suh JH, Miller VA, Ali SM, Stoopler M, Bulman WA. Yield and Clinical Utility of Next-Generation Sequencing in Selected Patients With Lung Adenocarcinoma. Clin Lung Cancer 2016; 17:517-522.e3. [PMID: 27378171 DOI: 10.1016/j.cllc.2016.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/27/2016] [Accepted: 05/31/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Next-generation sequencing is available for assessing genomic alterations in non-small-cell lung cancer (NSCLC), although the performance characteristics and clinical utility has not been well characterized. This technique can be used to sequence hundreds of known cancer-associated genes. Our aim was to investigate the diagnostic success and clinically relevant results of extensive sequencing in NSCLC patients. PATIENTS AND METHODS A case series of 49 NSCLC patients was used to determine the success of extended next-generation sequencing, record genomic alterations, and evaluate clinical utility. Data were collected in a retrospective review. Sequencing was performed using a hybridization capture of 3320 exons from 236 cancer-related genes and 47 introns of 19 genes applied to ≥50 ng of DNA and sequenced to high, uniform coverage of 622 times. RESULTS Sequencing was successful in 29 of 32 (91%) surgical/excisional specimens, and 12 of 17 (71%) nonsurgical specimens including an endoscopic forceps biopsy, core needle biopsies, fine-needle aspirates, and effusion cytologies. All 5 transthoracic core needle biopsies failed. A total of 179 genomic alterations (average 4.37 per tumor) were found. A total of 63 were clinically relevant (average 1.54 per tumor). The most frequently mutated genes were tumor protein p53, cyclin-dependent kinase inhibitor 2A, megalencephalic leukoencephalopathy with subcortical cysts 1, rapamycin-insensitive companion of mammalian target of rapamycin, epithelial growth factor receptor, SWI/SNF Related, Matrix Associated, Actin Dependent Regulator Of Chromatin, Subfamily A, Member 4, cyclin-dependent kinase inhibitor 2B, phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit α, Kirsten rat sarcoma viral oncogene homolog, Erb-B2 receptor tyrosine kinase 2, Serine/Threonine Kinase 11, and NK2 Homeobox 1. Sequencing results led to a change in management in 7 of 49 cases (14.3%). CONCLUSION Extended next-generation sequencing was performed successfully in 41 (83.7%) cases of NSCLC using a range of pathology specimens. Testing had the potential to affect treatment decisions in selected patients.
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Affiliation(s)
- David M DiBardino
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
| | - Anjali Saqi
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY
| | | | | | | | | | | | - Mark Stoopler
- Division of Hematology/Oncology, Columbia University College of Physicians and Surgeons, New York, NY
| | - William A Bulman
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY
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22
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Truini A, Santos Pereira P, Cavazza A, Spagnolo P, Nosseir S, Longo L, Jukna A, Lococo F, Vincenzi G, Bogina G, Tiseo M, Rossi G. Classification of different patterns of pulmonary adenocarcinomas. Expert Rev Respir Med 2015; 9:571-86. [PMID: 26313326 DOI: 10.1586/17476348.2015.1083428] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The epidemic increase of adenocarcinoma histology accounting for more than 50% of primary lung malignancies and the advent of effective molecular targeted-therapies against specific gene alterations characterizing this tumor type have led to the reconsideration of the pathologic classification of lung cancer. The new 2015 WHO classification provided the basis for a multidisciplinary approach emphasizing the close correlation among clinical, radiologic and molecular characteristics and histopathologic pattern of lung adenocarcinoma. The terms 'bronchioloalveolar carcinoma' and 'mixed adenocarcinoma' have been eliminated, introducing the concepts of 'adenocarcinoma in situ', 'minimally invasive adenocarcinoma' and the use of descriptive predominant patterns in invasive adenocarcinomas (lepidic, acinar, papillary, solid and micropapillary patterns). 'Invasive mucinous adenocarcinoma' is the new definition for mucinous bronchioloalveolar carcinoma, and some variants of invasive adenocarcinoma have been included, namely colloid, enteric and fetal-type adenocarcinomas. A concise update of the immunomorphologic, radiological and molecular characteristics of the different histologic patterns of lung adenocarcinoma is reported here.
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Affiliation(s)
- Anna Truini
- a 1 Lung Cancer Unit, IRCCS AOU San Martino - IST and Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università di Genova, Genova, Italy
| | - Poliana Santos Pereira
- b 2 Operative Unit of Pathologic Anatomy Hospital "Maggiore della Carità" of Novara, Novara, Italy
| | - Alberto Cavazza
- c 3 Department of Oncology and Advanced Technologies, Operative Unit of Oncology, Arcispedale S. Maria Nuova/ I.R.C.C.S., Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Spagnolo
- d 4 Medical University Clinic, Canton Hospital Baselland, and University of Basel, Basel, Switzerland
| | - Sofia Nosseir
- e 5 Section of Pathologic Anatomy, University Hospital Policlinico of Modena, Modena, Italy
| | - Lucia Longo
- f 6 Medical Oncology Unit, Civic Hospital "Ramazzini", Carpi, Carpi, Italy
| | - Agita Jukna
- g 7 Pathology Institute, Pauls Stradins Clinical University Hospital, Riga, Riga, Latvia
| | - Filippo Lococo
- h 8 Department of Surgery, Operative Unit of Thoracic Surgery, Arcispedale S. Maria Nuova/ I.R.C.C.S., Reggio Emilia, Reggio Emilia, Italy
| | - Giada Vincenzi
- i 9 Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Bogina
- j 10 Section of Pathologic Anatomy, Hospital "Don Calabria", Negrar, Verona, Italy
| | - Marcello Tiseo
- k 11 Division of Medical Oncology University Hospital, Parma, Italy
| | - Giulio Rossi
- l 12 University Hospital of Modena, Modena, Italy
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