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2020, Volume 36, Number 2, Page(s) 173-177
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DOI: 10.5146/tjpath.2018.01446 |
Core Biopsy Diagnosis of ALK Positive Inflammatory Myofibroblastic Tumor of Lung: An Interesting Case |
Ritesh SACHDEV1, Ishani MOHAPATRA1, Shalini GOEL1, Kulbir AHLAWAT2, Neelam SHARMA3 |
1Department of Pathology, Lab Medicine and Transfusion Medicine, Medanta - The Medicity Hospital, SECTOR 38, GURGAON, INDIA
2Department of Radiology, Medanta - The Medicity Hospital, SECTOR 38, GURGAON, INDIA
3Department of Medical Oncology, Medanta - The Medicity Hospital, SECTOR 38, GURGAON, INDIA |
Keywords:
Anaplastic lymphoma kinase, Inflammatory myofibroblastic tumor, Lung, Immunohistochemistry, Core needle biopsy |
Inflammatory myofibroblastic tumor (IMT) of lung is a rare tumor, accounting for ~0.7% of all lung tumors with varied clinical and radiological
presentations. The origin of this tumor is unknown but some studies suggest that it might be a true neoplasm as some mutations on chromosome
2p23 of anaplastic lymphoma kinase (ALK) have been found to be related to this tumor. The morphology of IMT is quite vague and the
histopathological diagnosis is predominantly given on excision specimens; in fact, only 6.3% of cases are diagnosed based on analysis of biopsy
specimens alone. We illustrate a case of IMT diagnosed in a young male on core biopsy, where the case presented with a large tumor in the lung
with metastases to multiple sites that was hence unresectable. Post 3 months of treatment with Crizotinib, there was significant reduction in the
tumor size. Another interesting finding was that the ALK immunostain, which helped immensely in the diagnosis, was appreciated better on the
Ventana platform rather than on the Dako platform.
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