Department of Human Pathology, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
Hum Pathol. 2018 Aug;78:177-181. doi: 10.1016/j.humpath.2018.01.023. Epub 2018 Feb 2.
Here, we present a case of non-small cell lung carcinoma (NSCLC) with widespread and strong nuclear immunopositivity for both thyroid transcription factor-1 (TTF-1) and ΔNp63/p40 (p40). Double immunofluorescence for TTF-1 and p40 showed coexpression of both markers in the tumor cells. Furthermore, PTEN (pHis123Asp) and TP53 (pVal272Leu) mutations were identified as possible mitogenic driver mutations by next-generation sequencing. To the best of our knowledge, this is the first case of NSCLC harboring concurrent PTEN and TP53 mutations with widespread and strong coexpression of TTF-1 and p40, which has been confirmed in the resected specimen, and only the second documented case of NSCLC with TTF-1 and p40 diffuse coexpression in the carcinoma cells from the same individual. Our case illustrates the possibility that poorly differentiated NSCLCs with widespread and strong nuclear positivity for TTF-1 and p40 may be an underrecognized and new entity.
在这里，我们报告了一例非小细胞肺癌（NSCLC）病例，该病例的甲状腺转录因子-1（TTF-1）和 ΔNp63/p40（p40）均广泛且强烈呈核免疫阳性。TTF-1 和 p40 的双重免疫荧光显示肿瘤细胞中两种标志物的共表达。此外，通过下一代测序鉴定出 PTEN（pHis123Asp）和 TP53（pVal272Leu）突变可能是有丝分裂驱动突变。据我们所知，这是首例在切除标本中证实存在同时伴有 PTEN 和 TP53 突变且 TTF-1 和 p40 广泛且强烈共表达的 NSCLC，并且是第二例在同一患者的癌细胞中存在 TTF-1 和 p40 弥漫性共表达的 NSCLC 病例。我们的病例说明了一种可能性，即广泛且强烈表达 TTF-1 和 p40 的低分化 NSCLC 可能是一种认识不足的新型实体。
