Cytomorphological features of ALK‐positive lung adenocarcinomas: Psammoma bodies and signet ring cells. Issue 3 (29th December 2014)

• Record Type: Journal Article
• Authors: Pareja, Fresia; Crapanzano, John P.; Mansukhani, Mahesh M.; Bulman, William A.; Saqi, Anjali
• Is Part Of: Cancer cytopathology. Volume 123:Issue 3(2015:Mar.)
• Page Start: 162
• Page End: 170
• Publication Date: 2014-12-29
• Subjects: Cancer -- Cytopathology -- Periodicals; Pathology, Cellular -- Periodicals; Cytology -- Technique -- Periodicals; 611.01815
• DOI: 10.1002/cncy.21507
• Languages: English
• ISSNs: 1934-662X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncy21507-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Correlation between histology and genotype has been described in lung adenocarcinomas. For example, studies have demonstrated that adenocarcinomas with an anaplastic lymphoma kinase (<italic>ALK</italic>) gene rearrangement may have mucinous features. The objective of the current study was to determine whether a similar association can be identified in cytological specimens.</p> </sec> <sec id="cncy21507-sec-0002" sec-type="section"> <title>METHODS</title> <p>A retrospective search for <italic>ALK</italic>‐rearranged cytopathology (CP) and surgical pathology (SP) lung carcinomas was conducted. Additional <italic>ALK</italic>‐negative (‐) lung adenocarcinomas served as controls. For CP and SP cases, the clinical data (i.e., age, sex, and smoking history), architecture, nuclear features, presence of mucin‐containing cells (including signet ring cells), and any additional salient characteristics were evaluated.</p> </sec> <sec id="cncy21507-sec-0003" sec-type="section"> <title>RESULTS</title> <p>The search yielded 20 <italic>ALK</italic>‐positive (+) adenocarcinomas. Compared with patients with <italic>ALK</italic>(‐) lung adenocarcinomas (33 patients; 12 with epidermal growth factor receptor [<italic>EGFR</italic>]‐mutation, 11 with Kristen rat sarcoma [<italic>KRAS</italic>]‐mutation, and 10 wild‐type adenocarcinomas), patients with <italic>ALK</italic>(+) adenocarcinoma presented at a younger age; and there was no correlation noted with sex or smoking status. The most common histological pattern in SP was papillary/micropapillary. Mucinous features were associated with <italic>ALK</italic> rearrangement in SP specimens. Signet ring cells and psammoma bodies were evident in and significantly associated with <italic>ALK</italic>(+) SP and CP specimens. However, psammoma bodies were observed in rare adenocarcinomas with an <italic>EGFR</italic> mutation. Both the <italic>ALK</italic>(+) and <italic>ALK</italic>(−) groups had mostly high nuclear grade.</p> </sec> <sec id="cncy21507-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>Salient features, including signet ring cells and psammoma bodies, were found to be significantly associated with <italic>ALK</italic>(+) lung adenocarcinomas and are identifiable on CP specimens. Recognizing these may be especially helpful in the molecular triage of scant CP samples. <bold><italic>Cancer (Cancer Cytopathol)</italic> 2014</bold>. © <italic>2014 American Cancer Society</italic>. <bold><italic>Cancer (Cancer Cytopathol)</italic> 2015;123:162–170.</bold> © <italic>2014 American Cancer Society</italic>.</p> </sec> </abstract>