Kamide Yosuke, Kaira Kyoichi, Watanabe Takuya, Kuribayashi Shiko, Ozawa Atsushi, Koga Yasuhiko, Ono Akihiro, Sunaga Noriaki, Hisada Takeshi, Oyama Tetsunari, Yamada Masanobu
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Japan.
Intern Med. 2015;54(22):2905-9. doi: 10.2169/internalmedicine.54.4987. Epub 2015 Nov 15.
A 55-year-old woman was diagnosed with a tyrosine kinase inhibitor of anaplastic lymphoma kinase (ALK) rearrangement-positive lung adenocarcinoma and treated with chemotherapy consisting of crizotinib, a tyrosine kinase inhibitor of ALK, as second-line chemotherapy. However, the size of the metastatic adrenal lesion increased, and the patient died due to multiple organ failure. An autopsy report revealed that the metastatic lesion of the adrenal tumor was ALK rearrangement-positive pleomorphic carcinoma. The epithelial-mesenchymal transition (EMT) marker vimentin was immunohistochemically positive in both the lung and adrenal lesions. The present case report suggests the possibility of transformation into pleomorphic carcinoma as a result of EMT in patients with ALK rearrangement-positive lung cancer.
一名55岁女性被诊断为间变性淋巴瘤激酶（ALK）重排阳性的肺腺癌，并接受了克唑替尼（一种ALK酪氨酸激酶抑制剂）作为二线化疗的化疗方案。然而，肾上腺转移病灶增大，患者因多器官衰竭死亡。尸检报告显示，肾上腺肿瘤的转移病灶为ALK重排阳性的多形性癌。免疫组织化学检测显示，上皮-间质转化（EMT）标志物波形蛋白在肺和肾上腺病灶中均呈阳性。本病例报告提示，ALK重排阳性肺癌患者可能因EMT而转化为多形性癌。
