Incidentally proven pulmonary "ALKoma"

Intern Med. 2010;49(6):603-6. doi: 10.2169/internalmedicine.49.3126. Epub 2010 Mar 15.

Abstract

Genetic alterations of echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) inversion were recently found in lung cancer. A 39-year-old woman with multiple brain metastases and bulky mediastinal lymph node metastases was admitted. Biopsy from her supraclavicular lymph nodes was performed to differentiate the diagnosis between lymphoma and lung cancer. Pathologically, the lymph nodes had a feature of adenocarcinoma. On the other hand, the commercially available chromosomal fluorescent in situ hybridization (FISH) analysis showed split signals of ALK, which was confirmed to be the EML4-ALK inversion. The commercial-based ALK FISH is useful for screening pulmonary ALKoma.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / genetics*
  • Adult
  • Anaplastic Lymphoma Kinase
  • Biopsy
  • Cell Cycle Proteins / genetics*
  • Chromosome Inversion / genetics*
  • Diagnosis, Differential
  • Female
  • Humans
  • In Situ Hybridization, Fluorescence
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / genetics*
  • Lymph Nodes / pathology
  • Lymphoma / diagnosis
  • Lymphoma / pathology
  • Microtubule-Associated Proteins / genetics*
  • Protein-Tyrosine Kinases / genetics*
  • Receptor Protein-Tyrosine Kinases
  • Serine Endopeptidases / genetics*

Substances

  • Cell Cycle Proteins
  • Microtubule-Associated Proteins
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Protein-Tyrosine Kinases
  • Receptor Protein-Tyrosine Kinases
  • EML4 protein, human
  • Serine Endopeptidases