Lin Liping, Huang Fuxi, Chen Fang, He Yan, Hu Jiazhu, Cao Xiaolong
1 Department of Oncology, Panyu Central Hospital, Guangzhou, China.
3 Cancer Institute of Panyu, Guangzhou, China.
J Int Med Res. 2018 Aug;46(8):3491-3497. doi: 10.1177/0300060517748262. Epub 2018 Jan 8.
Pulmonary pleomorphic carcinoma (PPC) is rare, and the response of patients to conventional chemotherapy is very poor. Here we present a patient with anaplastic lymphoma kinase (ALK)-rearranged advanced PPC treated with crizotinib. Computed tomography revealed a mass in the left upper lung of a nonsmoking 60-year-old woman. Pathological findings using resected tissue were consistent with PPC stage 1A, T1bN0M0. Although the patient received adjuvant radiotherapy, the disease relapsed, quickly progressed, and remained PPC according to analysis of biopsied tissue. Although negative for epidermal growth factor receptor mutations, ALK rearrangements were detected in adenocarcinoma and spindle-cell components. The patient received crizotinib therapy and achieved a partial response for 7 months. This case indicates that patients with PPC, particularly those with adenocarcinoma, may harbor an epithelial component with the ALK rearrangement. Although the progression-free survival of patients treated with crizotinib is limited, they may obtain more benefit compared with conventional chemotherapy.
肺多形性癌（PPC）较为罕见，患者对传统化疗的反应很差。在此，我们报告1例接受克唑替尼治疗的间变性淋巴瘤激酶（ALK）重排的晚期PPC患者。计算机断层扫描显示，1名60岁不吸烟女性的左上肺有一个肿块。使用切除组织的病理检查结果符合PPC 1A期，T1bN0M0。尽管该患者接受了辅助放疗，但疾病复发，迅速进展，根据活检组织分析仍为PPC。虽然表皮生长因子受体突变呈阴性，但在腺癌和梭形细胞成分中检测到ALK重排。该患者接受了克唑替尼治疗，获得了7个月的部分缓解。该病例表明，PPC患者，尤其是腺癌患者，可能存在ALK重排的上皮成分。虽然接受克唑替尼治疗的患者无进展生存期有限，但与传统化疗相比，他们可能获得更多益处。
