肺浸润性黏液性腺癌病例，原发部位呈阶段性进展。
A case of invasive mucinous adenocarcinoma of the lung showing stepwise progression at the primary site.
机构信息
Doctoral Program in Biomedical Science, Graduate School of Comprehensive Human Science, University of Tsukuba, Ibaraki, Japan; Department of Pathology, University of Tsukuba Hospital, Ibaraki, Japan.
Department of Pathology, National Cancer Center Hospital East, Chiba, Japan.
出版信息
Lung Cancer. 2019 Oct;136:94-97. doi: 10.1016/j.lungcan.2019.08.027. Epub 2019 Aug 24.
OBJECTIVE
Invasive mucinous adenocarcinoma (IMA) is a variant of lung adenocarcinoma. We present one case of IMA with mixed mucinous and non-mucinous components, suggesting stepwise progression within the tumor.
MATERIAL AND METHOD
The two different components of IMA were separately examined by immunohistochemistry and performed amplicon sequencing (Ion Ampliseq Cancer Hotspot Panel v2, ilumina, San Diego, CA).
RESULT
Macroscopically, the IMA contained a small and well demarcated solid part. Tumor cells in the main part showed abundant intracytoplasmic mucin, whereas those in the solid part showed scant intracytoplasmic mucin and high-grade nuclear atypia. Both parts harbored the same KRAS p.G12 V mutation. The amplicon sequencing of the IMA showed oncogenic TP53 p.P278 L mutation was detected only in the solid part.
CONCLUSION
Oncogenetic TP53 mutation might promote stepwise progression of this case of IMA.
目的
浸润性黏液性腺癌（IMA）是肺腺癌的一种变体。我们报告了一例具有混合黏液性和非黏液性成分的 IMA，提示肿瘤内的逐步进展。
材料和方法
通过免疫组织化学分别检查 IMA 的两种不同成分，并进行扩增子测序（Ion Ampliseq Cancer Hotspot Panel v2，Illumina，圣地亚哥，CA）。
结果
大体上，IMA 包含一个小而边界清楚的实性部分。主要部分的肿瘤细胞显示丰富的细胞内黏液，而实性部分的肿瘤细胞显示少量细胞内黏液和高级别核异型性。两个部分都携带相同的 KRAS p.G12V 突变。IMA 的扩增子测序显示，仅在实性部分检测到致癌性 TP53 p.P278L 突变。
结论
oncogenetic TP53 突变可能促进了这种 IMA 的逐步进展。
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