{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:50:32Z","timestamp":1782215432165,"version":"3.54.5"},"reference-count":27,"publisher":"Termedia Sp. z.o.o.","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pol J Pathol"],"abstract":"<jats:p>Anaplastic lymphoma kinase (ALK) rearranged lung adenocarcinoma is frequently characterised by prominent mucin secretion and a\u00a0heterogeneous population of\u00a0mucinous cells. These histological features may result in misdiagnosis as invasive mucinous adenocarcinoma. &lt;br \/&gt;\nWe conducted a\u00a0comprehensive analysis of\u00a04 cases of\u00a0ALK-rearranged lung adenocarcinoma, focusing on the\u00a0clinicopathological features, genetic mutations, and clinical outcomes. Among these cases, 3 cases were initially diagnosed as invasive mucinous adenocarcinoma, while one case was identified as recurrent invasive mucinous adenocarcinoma. The\u00a0cohort comprised 3 female and 1 male patient\/s, with ages ranging from 47 to 63 years (mean age 54.8 years). &lt;br \/&gt;\nThe\u00a0tumour cells exhibited sieve-like tubular and solid signet ring structures, with evidence of\u00a0intracytoplasmic and extracellular mucin secretion. Immunohistochemical analysis demonstrated diffuse expression of\u00a0TTF-1, Napsin A, and ALK(D5F3) in tumour cells, while HNF4a, CK20, and MUC5AC were consistently negative. &lt;br \/&gt;\nNext-generation sequencing analysis confirmed ALK rearrangements in 3 cases. Accurate identification of\u00a0this specific subtype of\u00a0lung adenocarcinoma is essential for administering appropriate treatment and reducing the\u00a0risk of\u00a0potential misdiagnosis.<\/jats:p>","DOI":"10.5114\/pjp.2025.155788","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T09:13:21Z","timestamp":1762334001000},"page":"187-194","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathological features of\u00a0anaplastic lymphoma kinase-rearranged lung adenocarcinoma initially misdiagnosed with invasive mucinous adenocarcinoma \u2013 a\u00a0retrospective study"],"prefix":"10.5114","volume":"76","author":[{"given":"Xiaomin","family":"Dai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyue","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanbo","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3061","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"ref-1687689","doi-asserted-by":"crossref","unstructured":"Nicholson AG, Tsao MS, Beasley MB, Borczuk AC, Brambilla E, Cooper WA, et al. The\u00a02021 WHO classification of\u00a0lung tumors: impact of\u00a0advances since 2015. J Thorac Oncol 2022; 17: 362-387.","DOI":"10.1016\/j.jtho.2021.11.003"},{"key":"ref-1687690","doi-asserted-by":"crossref","unstructured":"Naruse I,\u00a0Ohmori T,\u00a0Ao Y,\u00a0Fukumoto H,\u00a0Kuroki T,\u00a0Mori M,\u00a0 et al. Antitumor activity of\u00a0the\u00a0selective epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) Iressa (ZD1839) in an EGFR-expressing multidrug-resistant cell line in vitro and in vivo. Int J Cancer 2002; 98: 310-315.","DOI":"10.1002\/ijc.10173"},{"key":"ref-1687691","unstructured":"Zhong S, Zhang HP, Zheng J, Bai DY, Fu L, Chen PQ. [Detection of\u00a0EML4-ALK fusion gene in non-small cell lung cancer and its clinicopathologic correlation]. Zhonghua Bing Li Xue Za Zhi 2016; 42: 252-256."},{"key":"ref-1687692","doi-asserted-by":"crossref","unstructured":"Be\u00e1ta S, Tibor G, Zolt\u00e1n H, G\u00e1bor T, Mirjam B, J\u00e1nos F, et al. Spatially resolved proteomic and transcriptomic profiling of\u00a0anaplastic lymphoma kinase-rearranged pulmonary adenocarcinomas reveals key players in inter- and intratumoral heterogeneity. Int J Mol Sci 2023; 24: 11369.","DOI":"10.3390\/ijms241411369"},{"key":"ref-1687693","doi-asserted-by":"crossref","unstructured":"Yoshida A, Tsuta K, Nakamura H, Kohno T, Takahashi F,  Asamura H, et al. Comprehensive histologic analysis of\u00a0ALK- rearranged lung carcinomas. Am J Surg Pathol 2011; 35: 1226-1234.","DOI":"10.1097\/PAS.0b013e3182233e06"},{"key":"ref-1687694","doi-asserted-by":"crossref","unstructured":"Giulio R, Alberto C, Luisella R, Giuliana S, Alessandra B, Lucia L, et al. Napsin-A, TTF-1, EGFR, and ALK status determination in lung primary and metastatic mucin-producing adenocarcinomas. Int J Surg Pathol 2014; 22: 401-407.","DOI":"10.1177\/1066896914527609"},{"key":"ref-1687695","doi-asserted-by":"crossref","unstructured":"Shim HS,\u00a0Kenudson M,\u00a0Zheng Z,\u00a0Liebers M,\u00a0Cha YJ,\u00a0Ho QH, et al. Unique genetic and survival characteristics of\u00a0invasive mucinous adenocarcinoma of\u00a0the\u00a0lung. J Thorac Oncol 2015; 10: 1156-1162.","DOI":"10.1097\/JTO.0000000000000579"},{"key":"ref-1687696","doi-asserted-by":"crossref","unstructured":"Chang WC, Zhang YZ, Nicholson AG. Pulmonary invasive mucinous adenocarcinoma. Histopathology 2024; 84: 18-31.","DOI":"10.1111\/his.15064"},{"key":"ref-1687697","doi-asserted-by":"crossref","unstructured":"Jennifer MB, Joseph JM, Jason AW, Jesse SV, Benjamin RK, Ping Y, et al. Pulmonary invasive mucinous adenocarcinoma and mixed invasive mucinous\/nonmucinous adenocarcinoma-a\u00a0clinicopathological and molecular genetic study with survival analysis. Hum Pathol 2018; 71: 8-19.","DOI":"10.1016\/j.humpath.2017.08.002"},{"key":"ref-1687698","doi-asserted-by":"crossref","unstructured":"Sumiyoshi S, Yoshizawa A, Sonobe M, Kobayashi M, Sato M, Fujimoto M, et al. Non-terminal respiratory unit type lung adenocarcinoma has three distinct subtypes and is associated with poor prognosis. Lung Cancer 2014; 84: 281-288.","DOI":"10.1016\/j.lungcan.2014.03.013"},{"key":"ref-1687699","doi-asserted-by":"crossref","unstructured":"Choi IH, Kim DW, Ha SY, Choi YL, Lee HJ, Han J. Analysis of\u00a0histologic features suspecting anaplastic lymphoma kinase (ALK)-expressing pulmonary adenocarcinoma. J Pathol Transl Med 2015; 49: 310-317.","DOI":"10.4132\/jptm.2015.05.13"},{"key":"ref-1687700","doi-asserted-by":"crossref","unstructured":"Masato S, Toru N, Eiichi S, Yoshiko M, Waki H, Toyoaki H,  et al. HNF4\uf061 as a\u00a0marker for invasive mucinous adenocarcinoma of\u00a0the\u00a0lung. Am J Surg Pathol 2013, 37(2): 211-218.","DOI":"10.1097\/PAS.0b013e31826be303"},{"key":"ref-1687701","doi-asserted-by":"crossref","unstructured":"Kim YK, Shin DH, Kim KB, Shin N, Park WY, Lee JH, et al. MUC5AC and MUC5B enhance the\u00a0characterization of\u00a0mucinous adenocarcinomas of\u00a0the\u00a0lung and predict poor prognosis. Histopathology 2015; 67: 520-528.","DOI":"10.1111\/his.12693"},{"key":"ref-1687702","doi-asserted-by":"crossref","unstructured":"Duruisseaux ML, Mcleer-Florin A, Antoine M, Alavizadeh S, Poulot V, Lacave R, et al. NRG1 fusion in a\u00a0French cohort of\u00a0invasive mucinous lung adenocarcinoma. Cancer Med 2016; 5: 3579-3585.","DOI":"10.1002\/cam4.838"},{"key":"ref-1687703","doi-asserted-by":"crossref","unstructured":"Hwang DH, Sholl LM, Rojas-Rudilla V, Hall DL, Shivdasani P, Garcia EP, et al. KRAS and NKX2-1 mutations in invasive mucinous adenocarcinoma of\u00a0the\u00a0lung. J Thorac Oncol 2016; 11: 496-503.","DOI":"10.1016\/j.jtho.2016.01.010"},{"key":"ref-1687704","doi-asserted-by":"crossref","unstructured":"Philipp J, Claudia V, Anke B, Nikolaj F, Alexander A, Denise T, et al. Next generation sequencing of\u00a0lung adenocarcinoma subtypes with intestinal differentiation reveals distinct molecular signatures associated with histomorphology and therapeutic options. Lung Cancer 2019; 138: 43-51.","DOI":"10.1016\/j.lungcan.2019.10.005"},{"key":"ref-1687705","doi-asserted-by":"crossref","unstructured":"Yoon Jin C, Joungho H, Soo Hyun H, Tae Bum L, Hojoong K, Jea ZJP. ALK-rearranged adenocarcinoma with extensive mucin production can mimic mucinous adenocarcinoma: clinicopathological analysis and comprehensive histological comparison with KRAS-mutated mucinous adenocarcinoma. Pathology 2016; 48: 325-329.","DOI":"10.1016\/j.pathol.2016.02.016"},{"key":"ref-1687706","doi-asserted-by":"crossref","unstructured":"Yuan L, Yunjian P, Rui W, Yihua S, Haichuan H, Xuxia S, et al. ALK-rearranged lung cancer in chinese: a\u00a0comprehensive assessment of\u00a0clinicopathology, IHC, FISH and RT-PCR. PLoS One 2013; 8: e69016.","DOI":"10.1371\/journal.pone.0069016"},{"key":"ref-1687707","doi-asserted-by":"crossref","unstructured":"Shi M,\u00a0Xu H,\u00a0DiPoto Brahmbhatt A,\u00a0Gonzalez-Toledo E, Georgescu MM. Hemorrhagic brain metastases in a\u00a0patient with anaplastic lymphoma kinase (ALK)-rearranged invasive mucinous adenocarcinoma of\u00a0the\u00a0lung. Am J Case Rep 2018; 19: 99-104.","DOI":"10.12659\/AJCR.906803"},{"key":"ref-1687708","doi-asserted-by":"crossref","unstructured":"Yoshida A, Tsuta K, Watanabe SI, Sekine I, Fukayama M, Tsuda H, et al. Frequent ALK rearrangement and TTF-1\/p63 co-expression in lung adenocarcinoma with signet-ring cell component. Lung Cancer 2011; 72: 309-315.","DOI":"10.1016\/j.lungcan.2010.09.013"},{"key":"ref-1687709","doi-asserted-by":"crossref","unstructured":"Shukla S, Husain N, Gupta A, Anand N. Cytomorphological features of\u00a0lung adenocarcinoma with anaplastic lymphoma kinase gene rearrangement. J Cytol 2019; 36: 8-12.","DOI":"10.4103\/JOC.JOC_127_18"},{"key":"ref-1687710","doi-asserted-by":"crossref","unstructured":"Naoto K, Masahiko O, Yukari W, Kaori Y, Keiko M, Kenji Y, et al. Cytological features in eight patients with ALK-rearranged lung cancer. Diagn Cytopathol 2017; 46: 516-519.","DOI":"10.1002\/dc.23879"},{"key":"ref-1687711","doi-asserted-by":"crossref","unstructured":"Jokoji R, Yamasaki T, Minami S, Komuta K, Sakamaki Y, Takeuchi K, et al. Combination of\u00a0morphological feature analysis and immunohistochemistry is useful for screening of\u00a0EML4-ALK-positive lung adenocarcinoma. J Clin Pathol 201; 63: 1066-1070.","DOI":"10.1136\/jcp.2010.081166"},{"key":"ref-1687712","doi-asserted-by":"crossref","unstructured":"Shaw AT, Yeap BY, Mino-Kenudson M, Digumarthy SR,  Costa DB. Clinical features and outcome of patients with non-small-cell lung cancer who harbor EML4-ALK. J Clin Oncol 2009; 27: 4247-4253.","DOI":"10.1200\/JCO.2009.22.6993"},{"key":"ref-1687713","doi-asserted-by":"crossref","unstructured":"Deng C, Zhang Y, Ma Z, Fu F, Deng L, Li Y, et al. Prognostic value of epidermal growth factor receptor gene mutation in resected lung adenocarcinoma. J Thorac Cardiovasc Surg 2021; 162: 664-674.","DOI":"10.1016\/j.jtcvs.2020.05.099"},{"key":"ref-1687714","doi-asserted-by":"crossref","unstructured":"Nie Y, Staley A, Hinz T, Merrick D, Yang M, Schenk EL, et al. High PD-L1 expression among patients with ALK rearranged non-small cell lung cancer and response to first line ALK tyrosine kinase inhibitors. 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Ann Oncol 2025; 36: 297-308.","DOI":"10.1016\/j.annonc.2024.11.014"}],"container-title":["Polish Journal of Pathology"],"original-title":[],"link":[{"URL":"https:\/\/www.polishjournalofpathology.com\/pdf-209381-136503","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.polishjournalofpathology.com\/pdf-209381-136503","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:11:25Z","timestamp":1782213085000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.polishjournalofpathology.com\/Clinicopathological-features-of-anaplastic-lymphoma-kinase-rearranged-lung-adenocarcinoma,209381,0,2.html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"alternative-id":["209381"],"URL":"https:\/\/doi.org\/10.5114\/pjp.2025.155788","relation":{},"ISSN":["1233-9687","2084-9869"],"issn-type":[{"value":"1233-9687","type":"print"},{"value":"2084-9869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]}}}