PMID- 35116685
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220205
IS  - 2219-6803 (Electronic)
IS  - 2218-676X (Print)
IS  - 2218-676X (Linking)
VI  - 10
IP  - 8
DP  - 2021 Aug
TI  - ALK-positive pulmonary adenocarcinoma with signet ring features (PASRF) and 
      polygonal cell morphology simultaneously co-expressing TTF-1/p63/P40: a case 
      report.
PG  - 3864-3869
LID - 10.21037/tcr-21-335 [doi]
AB  - Pulmonary adenocarcinoma with signet ring features (PASRF) is relatively rare and 
      often harbors anaplastic large cell kinase gene (ALK) rearrangements. As patients 
      with ALK+ lung adenocarcinoma typically present at advanced stages, it is 
      important to detect ALK+ PASRF at metastatic sites to ensure ALK-targeted therapy 
      can be best applied. In this study, we report a case of PASRF with polygonal cell 
      morphology in an 85-year-old female who had metastasized to the supraclavicular 
      lymph node and was treated with Alectinib, a novel small molecule tyrosine kinase 
      inhibitor targeting ALK. Biopsy of the node revealed numerous microscopic 
      neoplastic cells which had formed nests or cords, in addition to signet ring 
      cells (60%), and another morphology of polygonal cells (40%) which contained 
      eosinophilic cytoplasm. Mitotic images were common, and necrosis was observed. 
      Immunohistochemically, both morphology tumor cells were diffusely positive for 
      TTF1, CK7, and Napsin A, and most of the two were positive for P40, P63, and 
      CK5/6 and negative for CK20 and CDX2. Co-expression of TTF-1, CK7, Napsin A, and 
      P40, P63, and CK5/6 were overtly present, and Alcian blue-periodic acid-Schiff 
      (AB-PAS) staining showed intracytoplasmic mucin in the two cells. In addition, 
      ALK rearrangements were detected by ALK (clone D5F3) immunohistochemical assay 
      and fluorescence in situ hybridization (FISH), A final diagnosis of metastatic 
      ALK-positive PASRF with polygonal cell morphology to the supraclavicular lymph 
      node was made, and the patient was treated with Alectinib, which brought a 
      reduction in tumor size and good results.
CI  - 2021 Translational Cancer Research. All rights reserved.
FAU - Tan, Yang
AU  - Tan Y
AD  - Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-sen 
      University, Shenzhen, China.
FAU - Lu, Xiaofang
AU  - Lu X
AD  - Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-sen 
      University, Shenzhen, China.
FAU - Li, Yun
AU  - Li Y
AD  - Department of Thoracic Surgery, The Seventh Affiliated Hospital of Sun Yat-sen 
      University, Shenzhen, China.
FAU - Liao, Dingzhun
AU  - Liao D
AD  - Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-sen 
      University, Shenzhen, China.
FAU - Xie, Wenlin
AU  - Xie W
AD  - Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-sen 
      University, Shenzhen, China.
FAU - Song, Jian
AU  - Song J
AD  - Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-sen 
      University, Shenzhen, China.
FAU - Xue, Ling
AU  - Xue L
AD  - Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-sen 
      University, Shenzhen, China.
FAU - Zhu, Junfeng
AU  - Zhu J
AD  - Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-sen 
      University, Shenzhen, China.
LA  - eng
PT  - Case Reports
PL  - China
TA  - Transl Cancer Res
JT  - Translational cancer research
JID - 101585958
PMC - PMC8797292
OTO - NOTNLM
OT  - Pulmonary adenocarcinoma
OT  - case report
OT  - lymph node metastasis
OT  - polygonal cell
OT  - signet ring cell
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at https://dx.doi.org/10.21037/tcr-21-335). The authors have no 
      conflicts of interest to declare.
EDAT- 2022/02/05 06:00
MHDA- 2022/02/05 06:01
PMCR- 2021/08/01
CRDT- 2022/02/04 05:49
PHST- 2021/02/23 00:00 [received]
PHST- 2021/05/14 00:00 [accepted]
PHST- 2022/02/04 05:49 [entrez]
PHST- 2022/02/05 06:00 [pubmed]
PHST- 2022/02/05 06:01 [medline]
PHST- 2021/08/01 00:00 [pmc-release]
AID - tcr-10-08-3864 [pii]
AID - 10.21037/tcr-21-335 [doi]
PST - ppublish
SO  - Transl Cancer Res. 2021 Aug;10(8):3864-3869. doi: 10.21037/tcr-21-335.