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Colliding primary lung cancers of adenosquamous carcinoma and large cell neuroendocrine carcinoma
Author(s) -
Yazawa Takuya,
Ishii Haruhiko,
Ito Takaaki,
Yoshiike Yasuhiro,
Ogawa Nobuo,
Okudela Koji,
Hayashi Hiroyuki,
Suzuki Takehisa,
Mitsui Hideaki,
Ikeda Masaichi,
Kitamura Hitoshi
Publication year - 2003
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1046/j.1440-1827.2003.01428.x
Subject(s) - pathology , adenosquamous carcinoma , neuroendocrine differentiation , biology , carcinoma , large cell , adenocarcinoma , cancer , medicine , prostate cancer , genetics
We report an extremely rare case of primary lung cancer showing various histological elements diagnosed as the collision of an adenosquamous carcinoma and a large cell neuroendocrine carcinoma by loss of heterozygosity (LOH) analysis of the human androgen receptor (AR) and phosphoglycerate kinase (PGK‐1) genes. The tumor exhibited a tiny ground‐glass opaque shadow suggesting atypical adenomatous hyperplasia 18 months prior to surgery. However, the tumor grew rapidly, and the resected tumor consisted of two closely located nodules. The larger nodule was composed of well‐differentiated adenocarcinomatous and moderately to poorly differentiated squamous cell carcinomatous elements, while the smaller nodule consisted of a large cell neuroendocrine carcinomatous element with partial squamoid differentiation having focal continuity with the adenocarcinomatous element. Both the adenocarcinomatous and squamous cell carcinomatous elements revealed transitional features and LOH of AR and PGK‐1 genes, while the large cell neuroendocrine carcinomatous element showed a monoclonal pattern but possessed both alleles of AR and PGK‐1 genes. From these clinical and pathological results, the parental cell of the large cell neuroendocrine carcinomatous element was considered to be different from that of the adenosquamous carcinomatous element.