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Histomorphologic features of lung adenocarcinomas exhibiting ALK gene rearrangement

Daniel S Grosser1, Haiying Zhang1

  • 1Department of Pathology, Baylor University Medical CenterDallasTexas.

Proceedings (Baylor University. Medical Center)
|June 14, 2019
PubMed

Insights

Identifying ALK rearrangements in lung adenocarcinoma is crucial for targeted therapy. While certain histomorphologic patterns suggest ALK positivity, molecular testing is essential for accurate diagnosis and treatment selection.

Area of Science:

  • Oncology
  • Pathology
  • Genetics

Background:

  • Tyrosine kinase inhibitors (TKIs) have revolutionized cancer treatment, necessitating precise identification of targetable genetic alterations.
  • Anaplastic lymphoma kinase (ALK) gene rearrangements are key biomarkers in a subset of lung adenocarcinomas, predicting response to specific TKIs like crizotinib.

Observation:

  • This study retrospectively reviewed 10 lung adenocarcinoma cases with confirmed ALK rearrangements.
  • Histomorphologic features, including acinar, papillary, micropapillary, and solid patterns, along with cribriform, signet ring, and extracellular mucin, were analyzed.
  • Acinar patterns (simple and cribriform) were most prevalent, followed by papillary patterns.

Findings:

  • The study observed that specific histomorphologic patterns are associated with ALK rearrangements in lung adenocarcinoma.
  • Acinar and papillary patterns were the most common histomorphologic features in ALK-positive cases.
  • However, histomorphologic features alone are not sufficiently sensitive or specific for definitive ALK rearrangement diagnosis.

Implications:

  • Histomorphology can serve as a preliminary indicator for potential ALK rearrangements in lung adenocarcinoma.
  • Comprehensive molecular testing remains indispensable for accurate diagnosis and guiding TKI therapy selection.
  • Accurate identification of ALK-positive lung adenocarcinomas ensures optimal patient management and therapeutic outcomes.
Keywords:
ALK rearrangementhistomorphologylung adenocarcinomatyrosine kinase inhibitors

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