An anaplastic lymphoma kinase-positive lung cancer microlesion: A case report

Tetsuo Kon, Youichiro Baba, Ichiro Fukai, Gen Watanabe, Tomoko Uchiyama, Tetsuya Murata
2017 Human Pathology: Case Reports  
Anaplastic lymphoma kinase (ALK)-positive lung cancers are generally diagnosed at an advanced clinical stage. Herein, we report a case of an ALK-positive lung cancer patient who had a microlesion of this tumor type. The patient was a 51-year-old woman without a smoking history. Computed tomography performed during a lung cancer screening program showed a 7 × 5-mm subpleural nodule with an irregular border in the right lower lobe. The background lung parenchyma was almost normal. Serum tumor
more » ... er levels were not elevated. Histological assessment showed destructive growth in the center of the lesion, as confirmed using Victoria bluehematoxylin and eosin staining and immunostaining for CD34 and D2-40; however, at the other site, the tumor mainly showed intra-alveolar growth with minor lepidic growth. The tumor cells were positive for thyroid transcription factor-1 and ALK. Fluorescent in situ hybridization of the tumor revealed an ALK gene spilt. Accordingly, the tumor was diagnosed as ALK-positive lung cancer. ALK-positive lung cancer presents diverse histological architectures in the early phase.
doi:10.1016/j.ehpc.2016.04.001 fatcat:qfasheodvvc6bnehr22z455die