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Updated: Feb 10, 2026

Comparative Lesions Analysis Through a Targeted Sequencing Approach
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Comparative Lesions Analysis Through a Targeted Sequencing Approach

Published on: November 5, 2019

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Clonally-related primary ALK rearranged adenocarcinoma and associated metastatic lesions

You-Cai Zhu1, Yun-Te Deng2, Wen-Xian Wang3

  • 1Chest Disease Diagnosis and Treatment Center, Zhejiang Rongjun Hospital, Jiaxing, China.

Thoracic Cancer
|May 9, 2018
PubMed

Insights

Anaplastic lymphoma kinase (ALK) rearrangement drives non-small cell lung cancer (NSCLC). Histological differences in tumors did not alter the ALK genotype, guiding personalized TKI therapy.

Area of Science:

  • Oncology
  • Genetics
  • Personalized Medicine

Background:

  • Anaplastic lymphoma kinase (ALK) rearrangement is a key driver in non-small cell lung cancer (NSCLC).
  • ALK-positive NSCLC exhibits sensitivity to ALK-tyrosine kinase inhibitors (TKIs).
  • Accurate detection of driver gene alterations is essential for tailoring cancer treatments.

Observation:

  • A 42-year-old male patient presented with adenocarcinoma featuring diverse histomorphologies: mucinous type in the primary lung tumor and solid type in lymph node metastasis.
  • Genomic analysis revealed ALK rearrangement in both tumor types, with no EGFR mutation detected.
  • Despite distinct histological patterns, the underlying genotype remained consistent.

Findings:

  • Histological heterogeneity between primary and metastatic sites does not always signify genomic divergence.
  • Genomic profiling complements histological assessment in identifying ALK-rearranged lung adenocarcinomas.
  • Consistent ALK rearrangement across different histomorphologies supports a unified diagnostic and therapeutic approach.

Implications:

  • Genomic analysis is crucial for identifying actionable targets like ALK rearrangements, irrespective of tumor histology.
  • Understanding consistent genotypes in heterogeneous tumors aids in selecting appropriate TKIs for non-small cell lung cancer.
  • This case highlights the importance of molecular testing in guiding personalized treatment strategies for NSCLC patients.
Keywords:
ALKhistologymetastasisnon-small-cell lung cancer

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