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Updated: May 18, 2026
Use of Electromagnetic Navigational Transthoracic Needle Aspiration (E-TTNA) for Sampling of Lung Nodules
Published on: May 23, 2015
[Cavitating nodules in a 40-year-old non-smoking woman: a very particular tumour]
M-V Albahary1, G Ferretti, S Lantuejoul
1PCMAC Clinique de Pneumologie, CHU A. Michallon, BP 217X, 38043 Grenoble Cedex, France.
Introduction:
EML4-ALK fusion gene, is found in 3 to 5 % of lung adenocarcinoma and can be targeted by tyrosine-kinase inhibitor (TKI) with impressive therapeutic results.
Case Report:
We report the case of a non-smoking 40-year-old woman, diagnosed with metastatic poorly differentiated papillary adenocarcinoma of the lung harbouring the ALK fusion gene. After six cycles of first line chemotherapy with cisplatine-vinorelbine followed by maintenance treatment with erlotinib, the patient achieved a partial response. After disease progression, the patient was included in a trial comparing crizotinib with a classic 2nd line chemotherapy. After 1 month of crizotinib, the patient's condition improved. CT of the chest showed a near-total regression of bilateral pulmonary nodules replaced by pulmonary cysts.
Conclusion:
We report in this case a dramatic improvement with near-complete vanishing of pulmonary nodules replaced by pulmonary cysts in a patient treated with crizotinib. This case reminds us of the potential importance of evaluating the molecular diagnosis in lung cancers and especially in adenocarcinoma of the lung.
Insights
A patient with ALK-positive lung adenocarcinoma experienced significant improvement with crizotinib treatment. Pulmonary nodules regressed, replaced by cysts, highlighting the importance of molecular diagnosis in lung cancer.
Area of Science:
- Oncology
- Molecular Biology
Background:
- The EML4-ALK fusion gene occurs in 3-5% of lung adenocarcinomas.
- ALK fusions are targetable with tyrosine-kinase inhibitors (TKIs) for significant therapeutic outcomes.
Observation:
- A 40-year-old non-smoking woman with metastatic, poorly differentiated papillary lung adenocarcinoma harboring an ALK fusion gene was treated.
- Initial chemotherapy (cisplatin-vinorelbine) followed by erlotinib maintenance yielded a partial response.
- Disease progression led to treatment with crizotinib in a clinical trial.
Findings:
- Crizotinib treatment resulted in rapid clinical improvement within one month.
- Chest CT revealed near-total regression of pulmonary nodules, replaced by pulmonary cysts.
Implications:
- This case demonstrates a dramatic response to crizotinib in an ALK-positive lung adenocarcinoma patient.
- Highlights the critical role of molecular profiling for guiding lung cancer treatment decisions.
- Suggests potential for cyst formation as a response marker in ALK-targeted therapy.
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