A case in which the signet ring cell component of ALK-positive pulmonary carcinoma was detected by EBUS-TBNA

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  • EBUS-TBNA で印環細胞成分を含む ALK 陽性肺癌を認めた 1 例

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Abstract

<p>Background : Primary signet ring cell carcinoma occurs more frequently in the stomach, and rarely in the lung. We report a case of solid adenocarcinoma (anaplastic lymphoma kinase [ALK]-positive) of pulmonary origin exhibiting signet ring cell morphology diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy.</p><p>Case : A man in his 50 s visited our medical center complaining of hoarseness of the voice. After computed tomographic imaging, 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) showed lung cancer with multiple lymph node and bone metastases. It was judged that lymph node metastasis from solid adenocarcinomas can exhibit signet ring cell morphology on EBUS-TBNA cytology.</p><p>The gastric cancer was not detected by endoscopy. Histological examination of a biopsy specimen obtained from a left supraclavicular lymph node revealed atypical cells that showed positive immunohistochemical staining for TTF-1 and ALK. Thus, we made the final diagnosis of lymph node metastasis from ALK-positive adenocarcinoma.</p><p>Conclusion : Solid adenocarcinomas exhibiting signet ring cell morphology could arise from any organ. Primary lung carcinomas with signet ring cell morphology are often ALK-positive, and evidence of ALK expression by immunostaining leads to effective treatment.</p>

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