Differential Diagnosis of Primary Versus Metastatic Pulmonary Adenocarcinomas Using Gene Mutation Analyses: A Case Report Yoshimasa Nakazato, MD, Ryota.

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Differential Diagnosis of Primary Versus Metastatic Pulmonary Adenocarcinomas Using Gene Mutation Analyses: A Case Report Yoshimasa Nakazato, MD, Ryota Tanaka, MD, Erina Seki, MD, Misa Iijima, MD, Masaru Kojima, MD, Masakazu Yoshizumi, MS, Masahiko Kato, MD, Hirokazu Kimura, PhD, Kunihisa Kozawa, MD, Tomoyuki Goya, MD Journal of Thoracic Oncology Volume 3, Issue 8, Pages 931-934 (August 2008) DOI: 10.1097/JTO.0b013e3181802730 Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Microscopic findings of the right breast tumor reveal a ductal cancer cell type, and growth in well-defined nests (H&E stain, ×200). Journal of Thoracic Oncology 2008 3, 931-934DOI: (10.1097/JTO.0b013e3181802730) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Chest CT image of the left lower lobe (S9) shows a solid density with a regular margin, and the size is a 10 × 10 mm (A). CT image of the left lower lobe (S10) shows a solid density with a focal irregular margin on the lung window, and the size is a 8 × 8 mm (B). Journal of Thoracic Oncology 2008 3, 931-934DOI: (10.1097/JTO.0b013e3181802730) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 A, Microscopic findings of the resected tumor in the S10 reveal cuboidal to columnar shaped cells growing along the alveolar walls (H&E stain, A ×200). B, Microscopic findings of resected tumor in the S9 reveal a poorly differentiated subtype of adenocarcinoma with intracytoplasmic mucin droplets (H&E stain, B ×400). Journal of Thoracic Oncology 2008 3, 931-934DOI: (10.1097/JTO.0b013e3181802730) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 A sequence analysis of exon 6 from the tumor tissues. Codon 213 (the arrow) in the lung tumor of S10 is the normal base sequence (A). The arrow indicates a point mutation (codon 213; CGA→TGA) in the lung tumor of S9 (B). The arrow indicates the point mutation (codon 213; CGA→TGA) in the breast cancer (C). Journal of Thoracic Oncology 2008 3, 931-934DOI: (10.1097/JTO.0b013e3181802730) Copyright © 2008 International Association for the Study of Lung Cancer Terms and Conditions