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- A case of concomitant EGFR/ALK alteration against a mutated EGFR background in early-stage lung adenocarcinoma
- Ki-Chang Lee, Jiwon Koh, Doo Hyun Chung, Yoon Kyung Jeon
- J Pathol Transl Med. 2021;55(2):139-144. Published online January 22, 2021
- DOI: https://doi.org/10.4132/jptm.2020.12.16
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Abstract
PDF - Rare cases of lung adenocarcinoma (LUAD) with concomitant epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) translocation have been reported. However, their clonal and evolutional relationship remains unclear. We report a case of early-stage EGFR-mutated LUAD with a focal concomitant EGFR/ALK alteration. A 63-year-old male underwent lobectomy to remove a 1.9-cm-sized lung nodule, which was diagnosed with EGFR-mutated LUAD. ALK immunohistochemistry (IHC) showed focal positivity within the part of the tumor characterized by lepidic pattern, also confirmed by fluorescence in-situ hybridization (FISH). Targeted next-generation sequencing was performed separately on the ALK IHC/FISH-positive and -negative areas. EGFR L833V/L858R mutations were detected in both areas, whereas EML4 (echinoderm microtubule-associated protein-like 4)-ALK translocations was confirmed only in the ALK IHC/FISH-positive area, suggesting the divergence of an EGFR/ALK co-altered subclone from the original EGFR-mutant clone. Our study suggests that concurrent alterations of EGFR and ALK can arise via divergent tumor evolution, even in the relatively early phases of tumorigenesis.
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Citations
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- Identification and validation of molecular subtype and prognostic signature for lung adenocarcinoma based on neutrophil extracellular traps
Yanhua Zuo, Guangyi Leng, Ping Leng
Pathology and Oncology Research.2023;[Epub] CrossRef - Machine Learning-Based Integration Develops a Macrophage-Related Index for Predicting Prognosis and Immunotherapy Response in Lung Adenocarcinoma
Zuwei Li, Minzhang Guo, Wanli Lin, Peiyuan Huang
Archives of Medical Research.2023; 54(7): 102897. CrossRef - Big data analysis identified a telomere-related signature predicting the prognosis and drug sensitivity in lung adenocarcinoma
Weiyi Zhang
Medicine.2023; 102(46): e35526. CrossRef
- Identification and validation of molecular subtype and prognostic signature for lung adenocarcinoma based on neutrophil extracellular traps
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