Polish Journal of Pathology
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Polish Journal of Pathology
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Original paper

Clinicopathological features of anaplastic lymphoma kinase-rearranged lung adenocarcinoma initially misdiagnosed with invasive mucinous adenocarcinoma – a retrospective study

Xiaomin Dai
1
,
Xiaoyue Feng
1
,
Yanbo Lu
1
,
Fang Peng
1

  1. Department of Pathology, Zhejiang Hospital, Zhejiang, China
Pol J Pathol 2025; 76 (3)
Online publish date: 2025/11/05
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1. Nicholson AG, Tsao MS, Beasley MB, Borczuk AC, Brambilla E, Cooper WA, et al. The 2021 WHO classification of lung tumors: impact of advances since 2015. J Thorac Oncol 2022; 17: 362-387.
2. Naruse I, Ohmori T, Ao Y, Fukumoto H, Kuroki T, Mori M,  et al. Antitumor activity of the selective epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) Iressa (ZD1839) in an EGFR-expressing multidrug-resistant cell line in vitro and in vivo. Int J Cancer 2002; 98: 310-315.
3. Zhong S, Zhang HP, Zheng J, Bai DY, Fu L, Chen PQ. [Detection of EML4-ALK fusion gene in non-small cell lung cancer and its clinicopathologic correlation]. Zhonghua Bing Li Xue Za Zhi 2016; 42: 252-256.
4. Beáta S, Tibor G, Zoltán H, Gábor T, Mirjam B, János F, et al. Spatially resolved proteomic and transcriptomic profiling of anaplastic lymphoma kinase-rearranged pulmonary adenocarcinomas reveals key players in inter- and intratumoral heterogeneity. Int J Mol Sci 2023; 24: 11369.
5. Yoshida A, Tsuta K, Nakamura H, Kohno T, Takahashi F, Asamura H, et al. Comprehensive histologic analysis of ALK- rearranged lung carcinomas. Am J Surg Pathol 2011; 35: 1226-1234.
6. Giulio R, Alberto C, Luisella R, Giuliana S, Alessandra B, Lucia L, et al. Napsin-A, TTF-1, EGFR, and ALK status determination in lung primary and metastatic mucin-producing adenocarcinomas. Int J Surg Pathol 2014; 22: 401-407.
7. Shim HS, Kenudson M, Zheng Z, Liebers M, Cha YJ, Ho QH, et al. Unique genetic and survival characteristics of invasive mucinous adenocarcinoma of the lung. J Thorac Oncol 2015; 10: 1156-1162.
8. Chang WC, Zhang YZ, Nicholson AG. Pulmonary invasive mucinous adenocarcinoma. Histopathology 2024; 84: 18-31.
9. Jennifer MB, Joseph JM, Jason AW, Jesse SV, Benjamin RK, Ping Y, et al. Pulmonary invasive mucinous adenocarcinoma and mixed invasive mucinous/nonmucinous adenocarcinoma-a clinicopathological and molecular genetic study with survival analysis. Hum Pathol 2018; 71: 8-19.
10. Sumiyoshi S, Yoshizawa A, Sonobe M, Kobayashi M, Sato M, Fujimoto M, et al. Non-terminal respiratory unit type lung adenocarcinoma has three distinct subtypes and is associated with poor prognosis. Lung Cancer 2014; 84: 281-288.
11. Choi IH, Kim DW, Ha SY, Choi YL, Lee HJ, Han J. Analysis of histologic features suspecting anaplastic lymphoma kinase (ALK)-expressing pulmonary adenocarcinoma. J Pathol Transl Med 2015; 49: 310-317.
12. Masato S, Toru N, Eiichi S, Yoshiko M, Waki H, Toyoaki H, et al. HNF4 as a marker for invasive mucinous adenocarcinoma of the lung. Am J Surg Pathol 2013, 37(2): 211-218.
13. Kim YK, Shin DH, Kim KB, Shin N, Park WY, Lee JH, et al. MUC5AC and MUC5B enhance the characterization of mucinous adenocarcinomas of the lung and predict poor prognosis. Histopathology 2015; 67: 520-528.
14. Duruisseaux ML, Mcleer-Florin A, Antoine M, Alavizadeh S, Poulot V, Lacave R, et al. NRG1 fusion in a French cohort of invasive mucinous lung adenocarcinoma. Cancer Med 2016; 5: 3579-3585.
15. Hwang DH, Sholl LM, Rojas-Rudilla V, Hall DL, Shivdasani P, Garcia EP, et al. KRAS and NKX2-1 mutations in invasive mucinous adenocarcinoma of the lung. J Thorac Oncol 2016; 11: 496-503.
16. Philipp J, Claudia V, Anke B, Nikolaj F, Alexander A, Denise T, et al. Next generation sequencing of lung adenocarcinoma subtypes with intestinal differentiation reveals distinct molecular signatures associated with histomorphology and therapeutic options. Lung Cancer 2019; 138: 43-51.
17. Yoon Jin C, Joungho H, Soo Hyun H, Tae Bum L, Hojoong K, Jea ZJP. ALK-rearranged adenocarcinoma with extensive mucin production can mimic mucinous adenocarcinoma: clinicopathological analysis and comprehensive histological comparison with KRAS-mutated mucinous adenocarcinoma. Pathology 2016; 48: 325-329.
18. Yuan L, Yunjian P, Rui W, Yihua S, Haichuan H, Xuxia S, et al. ALK-rearranged lung cancer in chinese: a comprehensive assessment of clinicopathology, IHC, FISH and RT-PCR. PLoS One 2013; 8: e69016.
19. Shi M, Xu H, DiPoto Brahmbhatt A, Gonzalez-Toledo E, Georgescu MM. Hemorrhagic brain metastases in a patient with anaplastic lymphoma kinase (ALK)-rearranged invasive mucinous adenocarcinoma of the lung. Am J Case Rep 2018; 19: 99-104.
20. Yoshida A, Tsuta K, Watanabe SI, Sekine I, Fukayama M, Tsuda H, et al. Frequent ALK rearrangement and TTF-1/p63 co-expression in lung adenocarcinoma with signet-ring cell component. Lung Cancer 2011; 72: 309-315.
21. Shukla S, Husain N, Gupta A, Anand N. Cytomorphological features of lung adenocarcinoma with anaplastic lymphoma kinase gene rearrangement. J Cytol 2019; 36: 8-12.
22. Naoto K, Masahiko O, Yukari W, Kaori Y, Keiko M, Kenji Y, et al. Cytological features in eight patients with ALK-rearranged lung cancer. Diagn Cytopathol 2017; 46: 516-519.
23. Jokoji R, Yamasaki T, Minami S, Komuta K, Sakamaki Y, Takeuchi K, et al. Combination of morphological feature analysis and immunohistochemistry is useful for screening of EML4-ALK-positive lung adenocarcinoma. J Clin Pathol 201; 63: 1066-1070.
24. Shaw AT, Yeap BY, Mino-Kenudson M, Digumarthy SR, Costa DB. Clinical features and outcome of patients with non-small-cell lung cancer who harbor EML4-ALK. J Clin Oncol 2009; 27: 4247-4253.
25. Deng C, Zhang Y, Ma Z, Fu F, Deng L, Li Y, et al. Prognostic value of epidermal growth factor receptor gene mutation in resected lung adenocarcinoma. J Thorac Cardiovasc Surg 2021; 162: 664-674.
26. Nie Y, Staley A, Hinz T, Merrick D, Yang M, Schenk EL, et al. High PD-L1 expression among patients with ALK rearranged non-small cell lung cancer and response to first line ALK tyrosine kinase inhibitors. J Clin Oncol 2024; 42: 8626-8626.
27. Di Federico A, Hong L, Elkrief A, Thummalapalli R, Coo- per AJ, Ricciuti B, et al. Lung adenocarcinomas with mucinous histology: clinical, genomic, and immune microenvironment characterization and outcomes to immunotherapy-based treatments and KRAS(G12C) inhibitors. Ann Oncol 2025; 36: 297-308.
Copyright: © 2025 Polish Association of Pathologists and the Polish Branch of the International Academy of Pathology This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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