PMC9327614_01
(A) PET/CT showing that an effusion can be seen in the oblique fissure of the left lung, and a nodular thickening was also seen near the pleura in the lower lobe of the left lung (between the two curves, standard uptake value (SUV) = 2.08). (B) PET/CT showing that a cystic mass can be seen in the ileocecal area (arrow, SUV = 2.28). (C) The pulmonary tumor revealed mucinous adenocarcinoma (H&E). (D) The postoperative pathology revealed a low-grade appendiceal mucinous neoplasm (H&E).
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The examination revealed effusion in the oblique fissure of the left lung, and nodular thickening (standard uptake value (SUV) = 2.08) was also present near the pleura in the lower lobe of the left lung (Figure 1A). In addition, a cystic mass (Figure 1B) was located in the ileocecal area, and the SUV at the edge of the mass was 2.28. The pathologic analysis of the pulmonary tumor revealed mucinous neoplasms (Figure 1C). However, postoperative pathology revealed a LAMN but not mucinous adenocarcinoma (Figure 1D).
(A) The tumor was accurately sampled from a section under the microscope (the orange line indicates the sampling range). (B) The sequencing results show that both tumors had the same mutation: KRAS (p.G12D), GNAS (p.R201H), and BRAF (p.R735Q). (C) The variant allele frequency is shown in scatter diagram.
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Tumor cells from sections of the tumors were accurately collected under a microscope for NGS because of the small number of tumor cells in the mucinous neoplasm (Figure 2A). The results illustrated that both tumors carried the same tumor-specific mutations, namely, KRAS (p.G12D), GNAS (p.R201H), and BRAF (p.R735Q) (Figures 2B, C), which indicated that the pulmonary tumor was a metastasis of LAMN.