Related Experiment Video
Updated: Apr 11, 2026
Comparative Lesions Analysis Through a Targeted Sequencing Approach
Published on: November 5, 2019
Different histopathology but the same clonality: ALK rearrangement in a patient with metastatic non-small-cell lung
Jing Zhao1, Jianya Zhou2, Zhen Chen1
1Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
Abstract:
EML4-ALK rearrangement is detected in 2% to 7% of lung adenocarcinomas, these tumors are sensitive to crizotinib. The histologic feature of ALK translocated non-small-cell lung cancer (NSCLC) has been studied, presence of signet-ring cells was a powerful histologic indicator of ALK rearrangement, and this characteristic histology was present both in primary sites and metastases. However, the case we discribed here has different histomorphology in primary sites and metastases, but has the same genotype which both present ALK rearrangement, while absent of EGFR mutation, KRAS mutation and ROS1 rearrangement. This histologic heterogeneity may be a supplement of the histologic feature of ALK rearranged tumor. Moreover, genomic analysis can help distinguish clonal tumors from independent primaries.
Insights
EML4-ALK rearrangement in lung adenocarcinoma can present with varied histology. Genomic analysis aids in distinguishing clonal tumors, even with differing histomorphology between primary sites and metastases.
Area of Science:
- Oncology
- Genetics
- Pathology
Background:
- EML4-ALK rearrangement occurs in 2-7% of lung adenocarcinomas, conferring sensitivity to crizotinib.
- Signet-ring cells are a known indicator of ALK rearrangement in non-small-cell lung cancer (NSCLC).
- Histologic features can vary between primary tumors and metastases in ALK-rearranged NSCLC.
Observation:
- A case presented with distinct histomorphology in primary tumors and metastases.
- Both primary and metastatic sites harbored the same EML4-ALK rearrangement.
- EGFR, KRAS mutations, and ROS1 rearrangement were absent.
Findings:
- Histologic heterogeneity between primary and metastatic sites can occur in ALK-rearranged lung cancer.
- Genomic analysis confirmed a shared EML4-ALK genotype despite differing histology.
- This heterogeneity supplements the known histologic features of ALK-rearranged tumors.
Implications:
- Histologic variability should be considered in diagnosing ALK-rearranged lung cancer.
- Genomic profiling is essential for accurate tumor classification and treatment selection.
- Understanding tumor heterogeneity aids in distinguishing clonal origins from independent primaries.
More Related Videos
06:51Utilizing 18F-FDG PET/CT Imaging and Quantitative Histology to Measure Dynamic Changes in the Glucose Metabolism in Mouse Models of Lung Cancer
Published on: July 21, 2018
11:43Advanced Animal Model of Colorectal Metastasis in Liver: Imaging Techniques and Properties of Metastatic Clones
Published on: November 30, 2016