Watanabe Naoki, Ishii Tomoya, Takahama Takayuki, Tadokoro Akira, Kanaji Nobuhiro, Dobashi Hiroaki, Bandoh Shuji
Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Japan.
Intern Med. 2014;53(23):2711-5. doi: 10.2169/internalmedicine.53.2775. Epub 2014 Dec 1.
A 55-year-old woman was admitted for an evaluation of a mediastinal mass, bilateral cervical lymphadenopathy and a left breast tumor. Although pathology revealed a diagnosis of breast cancer, the cervical lymph nodes differed from the breast lesion. An anaplastic lymphoma kinase (ALK) gene analysis revealed ALK rearrangement in the cervical lymph nodes only, which were therefore diagnosed as reflective of metastasis of lung adenocarcinoma. The mediastinal tumor was also diagnosed as an ALK-positive lung adenocarcinoma based on its therapeutic response. ALK gene analyses can be used to identify primary lesions in patients with cancers of unknown primary sites.
一名55岁女性因纵隔肿块、双侧颈部淋巴结病和左乳肿瘤入院评估。尽管病理检查确诊为乳腺癌，但颈部淋巴结与乳腺病变不同。间变性淋巴瘤激酶（ALK）基因分析显示仅颈部淋巴结存在ALK重排，因此诊断为肺腺癌转移。纵隔肿瘤根据其治疗反应也被诊断为ALK阳性肺腺癌。ALK基因分析可用于识别原发部位不明的癌症患者的原发病灶。
