A case of invasive mucinous adenocarcinoma of the lung showing stepwise progression at the primary site

Lung Cancer. 2019 Oct:136:94-97. doi: 10.1016/j.lungcan.2019.08.027. Epub 2019 Aug 24.

Abstract

Objective: Invasive mucinous adenocarcinoma (IMA) is a variant of lung adenocarcinoma. We present one case of IMA with mixed mucinous and non-mucinous components, suggesting stepwise progression within the tumor.

Material and method: The two different components of IMA were separately examined by immunohistochemistry and performed amplicon sequencing (Ion Ampliseq Cancer Hotspot Panel v2, ilumina, San Diego, CA).

Result: Macroscopically, the IMA contained a small and well demarcated solid part. Tumor cells in the main part showed abundant intracytoplasmic mucin, whereas those in the solid part showed scant intracytoplasmic mucin and high-grade nuclear atypia. Both parts harbored the same KRAS p.G12 V mutation. The amplicon sequencing of the IMA showed oncogenic TP53 p.P278 L mutation was detected only in the solid part.

Conclusion: Oncogenetic TP53 mutation might promote stepwise progression of this case of IMA.

Keywords: Invasive mucinous adenocarcinoma (IMA); KRAS mutation; Stepwise progression; TP53 mutation.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma of Lung / diagnosis*
  • Adenocarcinoma of Lung / metabolism
  • Adenocarcinoma, Mucinous / diagnosis*
  • Adenocarcinoma, Mucinous / metabolism
  • Aged, 80 and over
  • Biomarkers
  • Biopsy
  • Disease Progression
  • Gene Expression
  • Humans
  • Immunohistochemistry
  • Male
  • Mucins / genetics
  • Mucins / metabolism
  • Mutation
  • Neoplasm Staging
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Proto-Oncogene Proteins p21(ras) / metabolism
  • Tumor Suppressor Protein p53 / genetics
  • Tumor Suppressor Protein p53 / metabolism

Substances

  • Biomarkers
  • KRAS protein, human
  • Mucins
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • Proto-Oncogene Proteins p21(ras)