A cytological study of EML4-ALK mutations in lung cancer

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  • EML4-ALK 融合遺伝子陽性肺癌の細胞学的検討

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Objective : Since characteristic histological findings of ALK-positive lung cancer have been reported, we investigated the cytological findings.<br>Study Design : Using 48 samples obtained from 46 patients with pulmonary adenocarcinoma in whom examination had been performed for the ALK fusion gene and examination of cytology preparations was possible, the cytological findings were compared between the ALK-positive and-negative groups.<br>Results : In the ALK-positive group, mainly small atypical cells were present in aggregates in imprint preparations, and cells containing mucus in the cytoplasm and signet-ring cells were observed. The nuclei were mostly small, and irregularity of the nuclear shape was mild to moderate ; there was also a small admixture of large cells. In body fluid preparations, a large number of cellular aggregates was observed, with the aggregates being larger in the ALK-positive group.<br>Conclusion : It is difficult to judge the presence or absence of the ALK fusion gene based on the cytological findings alone, however, when mainly small atypical cells containing clear nucleoli are present in addition to mucus-producing cells and signet-ring cells in imprint preparations, with a small admixture of large atypical cells, or when large cell aggregates are present in body fluid preparations, the possibility of ALK-positive lung cancer should be considered.

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