The Role of KRAS Mutational Analysis to Determine the Site of Origin of Metastatic Carcinoma to the Lung: A Case Report

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...

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Main Authors: Ahmed N. Alkhasawneh, Hui-Jia Dong, Chen Liu, Carmen Allegra, Robert W. Allan
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Pathology
Online Access:http://dx.doi.org/10.1155/2012/425967
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author Ahmed N. Alkhasawneh
Hui-Jia Dong
Chen Liu
Carmen Allegra
Robert W. Allan
author_facet Ahmed N. Alkhasawneh
Hui-Jia Dong
Chen Liu
Carmen Allegra
Robert W. Allan
author_sort Ahmed N. Alkhasawneh
collection DOAJ
description 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.
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spelling doaj-art-d302a63f21b248c2a8fdbab835b9a4732025-02-03T01:28:02ZengWileyCase Reports in Pathology2090-67812090-679X2012-01-01201210.1155/2012/425967425967The Role of KRAS Mutational Analysis to Determine the Site of Origin of Metastatic Carcinoma to the Lung: A Case ReportAhmed N. Alkhasawneh0Hui-Jia Dong1Chen Liu2Carmen Allegra3Robert W. Allan4Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, P.O. Box 100275, 1600 SW Archer Road, Gainesville, FL 32610, USADepartment of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, P.O. Box 100275, 1600 SW Archer Road, Gainesville, FL 32610, USADepartment of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, P.O. Box 100275, 1600 SW Archer Road, Gainesville, FL 32610, USADivision of Hematology and Oncology, College of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USADepartment of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, P.O. Box 100275, 1600 SW Archer Road, Gainesville, FL 32610, USAMetastatic 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.http://dx.doi.org/10.1155/2012/425967
spellingShingle Ahmed N. Alkhasawneh
Hui-Jia Dong
Chen Liu
Carmen Allegra
Robert W. Allan
The Role of KRAS Mutational Analysis to Determine the Site of Origin of Metastatic Carcinoma to the Lung: A Case Report
Case Reports in Pathology
title The Role of KRAS Mutational Analysis to Determine the Site of Origin of Metastatic Carcinoma to the Lung: A Case Report
title_full The Role of KRAS Mutational Analysis to Determine the Site of Origin of Metastatic Carcinoma to the Lung: A Case Report
title_fullStr The Role of KRAS Mutational Analysis to Determine the Site of Origin of Metastatic Carcinoma to the Lung: A Case Report
title_full_unstemmed The Role of KRAS Mutational Analysis to Determine the Site of Origin of Metastatic Carcinoma to the Lung: A Case Report
title_short The Role of KRAS Mutational Analysis to Determine the Site of Origin of Metastatic Carcinoma to the Lung: A Case Report
title_sort role of kras mutational analysis to determine the site of origin of metastatic carcinoma to the lung a case report
url http://dx.doi.org/10.1155/2012/425967
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