Difference in Clonality as a Tool for Differential Diagnosis of Primary Versus Secondary Lung Neoplasms Giovanni Leuzzi, MD, Alfredo Cesario, MD, Maria.

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Presentation transcript:

Difference in Clonality as a Tool for Differential Diagnosis of Primary Versus Secondary Lung Neoplasms Giovanni Leuzzi, MD, Alfredo Cesario, MD, Maria Letizia Vita, MD, Anna Mariantonia Parisi, MD, Gianluigi Petrone, MD, Maurizio Martini, MD, Guido Rindi, PhD, Pierluigi Granone, PhD Journal of Thoracic Oncology Volume 7, Issue 5, Pages 934-936 (May 2012) DOI: 10.1097/JTO.0b013e31824a82b5 Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 CT scan revealed (A) a round irregularly shaped lesion in the left upper lobe (LUL), 1.8 cm in the major axis; (C) synchronous pseudonodular contralateral lesion in the right upper lobe (RUL), measuring 1.4 cm. The PET-CT scan characterized (B) the LUL lesion with a SUV of 7.3 (D)and the RUL one of 1.7. Journal of Thoracic Oncology 2012 7, 934-936DOI: (10.1097/JTO.0b013e31824a82b5) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 (A) Moderately differentiated component of the left upper lobe (LUL) adenocarcinoma composed of papillary structures with a central fibrovascular core lined by columnar cells with moderate cyto-nuclear atypia; neoplastic cells exhibit a diffuse nuclear immunoreactivity for TTF-a (B), (A) Haematoxylin and eosin (B) haematoxylin counterstaining; original magnification ×200, (C) Poorly differentiated component of the LUL adenocarcinoma with a solid grow pattern, composed of sheets of polygonal cells sometimes markedly anaplastic with a high mitotic count and a weak and focal nuclear positivity for TTF-1 (D), (C) Haematoxylin and eosin (D) haematoxylin counterstaining, original magnification ×200, (E) The right upper lobe neoplasm is a moderately differentiated adenocarcinoma showing the same morphological and immunohystochemical features of the first, with papillary structures lined by columnar cells diffusely stained for TTF-1 in a nuclear pattern (F), (E) Haematoxylin and eosin, (F) haematoxylin counterstaining, original magnification × 200. Journal of Thoracic Oncology 2012 7, 934-936DOI: (10.1097/JTO.0b013e31824a82b5) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Partial nucleotide sequence of (A) exon 19 and (B) exon 21 of the EGFR gene. The exon 19 shows a heterozygous deletion of five amino-acids from 746 to 750 position (ΔE746–A750) as shown by the arrow indicating the starting point of frame shift. The exon 21 shows a heterozygous mutation at code 858 (CTG > CGG) with a substitution of arginine for leucine at position 858 (L858R); the arrow indicates the point mutation (T > G). Journal of Thoracic Oncology 2012 7, 934-936DOI: (10.1097/JTO.0b013e31824a82b5) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions