The Role of KRAS Mutational Analysis to Determine the Site of Origin of Metastatic Carcinoma to the Lung: A Case Report. (17th October 2012)

• Record Type: Journal Article
• Authors: Alkhasawneh, Ahmed N.; Dong, Hui-Jia; Liu, Chen; Allegra, Carmen; Allan, Robert W.
• Other Names: Chaudhry I. A. Academic Editor.; Hasebe T. Academic Editor.; Kuwabara H. Academic Editor.; Miliaras D. Academic Editor.
• Is Part Of: Case reports in pathology. Volume 2012(2012)
• Publication Date: 2012-10-17
• Subjects: Pathology -- Periodicals; Pathology; Pathology; Electronic journals; Periodicals; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 616.07
• DOI: 10.1155/2012/425967
• Languages: English
• ISSNs: 2090-6781

Abstract

Abstract : Metastatic carcinomas involving the lung are a common specimen encountered in surgical pathology. These metastases may have different morphologic, and architectural patterns and may mimic primary pulmonary adenocarcinoma, especially the intra-alveolar (lepidic) pattern of spread which may simulate a primary pulmonary bronchioloalveolar carcinoma (adenocarcinoma in situ). We present the case of a metastatic pancreatic adenocarcinoma that morphologically mimicked bronchioloalveolar carcinoma of the lung in that the tumor had an exclusive intra-alveolar pattern of spread and had an immunophenotype that was noninformative as to the site of origin (cytokeratin 7+, cytokeratin 20−, TTF-1−). In this case, we used KRAS gene mutation analysis to support that the lung carcinoma represented a metastatic pancreatic carcinoma as they both possessed identical codon 12 KRAS mutations. We show that this method may be a useful way to prove site of origin of metastatic carcinoma—particularly if standard morphologic or immunohistochemical analysis is not definitive.