Fig. 1Anaplastic lymphoma kinase (ALK) immunohistochemistry and fluorescence in situ hybridization. (A) Tumor cells show diffuse strong positivity for ALK in immunohistochemistry. (B) FISH analysis using dual color ALK break-apart probe shows one red, one green, and one fused signal indicating one rearranged ALK gene and one intact ALK gene.
Fig. 2Pathologic features of renal cell carcinoma showing anaplastic lymphoma kinase (ALK) rearrangement. (A) Grossly, the tumor is a well-circumscribed, partially cystic mass. Microscopically, the tumor shows a papillary (B), tubular or solid pattern (C) with occasional foam cell collections (D).
Fig. 3Immunohistochemical findings of renal cell carcinoma showing anaplastic lymphoma kinase (ALK) rearrangement. The tumor cells are positive for cytokeratin 7 (A), PAX-2 (B), and focal positive for CD10 (C) and negative for alpha-methylacyl-CoA racemase (D).
Table 1.Seven ALK-positive renal cell carcinomas
Case No. |
Age (yr) |
Sickle cell trait |
Subtype |
Size (cm) |
Fuhrman grade |
TNM stage23
|
Follow-up |
Fusion partner |
Reference |
1 |
16/M |
Yes |
Indeterminate |
6.2 |
Not mentioned |
T1bN1M0 |
0.75 yr, alive, no evidence of disease |
VCL
|
Debelenko et al. [18] |
2 |
6/M |
Yes |
Medullary |
4.5 |
Not mentioned |
T1bN0M0 |
1.75 yr, alive, no evidence of disease |
VCL
|
Marino-Enriquez et al. [19] |
3 |
36/F |
No |
Unclassified |
4 |
Not mentioned |
T1aN0M0 |
2 yr, alive, no evidence of disease |
TPM3
|
Sugawara et al. [21] |
4 |
53/F |
No |
A: papillary, |
A: 2.5, |
Not mentioned |
T1aN0M0 |
7 yr, alive, no evidence of disease |
EML4
|
Sugawara et al. [21] |
B: clear cell (double cancer) |
B: 0.6 |
5 |
61/M |
No |
Papillary |
5 |
2 |
T1bNXM0 |
4 yr, death from disease |
Unchecked |
Sukov et al. [20] |
6 |
59/M |
No |
Papillary |
5.5 |
3 |
T1bNXM0 |
1.4 yr, death from disease |
Unchecked |
Sukov et al. [20] |
7 |
44/M |
No |
Papillary |
3 |
3 |
T1aN0M0 |
12 yr, alive, no evidence of disease |
Unchecked |
Present case |