PMC5499929_01
Hematoxylin-eosin staining and immunohistochemistry in adenocarcinoma before crizotinib treatment.. Notes: (A) Hematoxylin-eosin staining revealed that tumor cells were lung adenocarcinoma (x200). (B) Immunohistochemical examination revealed that tumor cells were positive for monoclonal anti-TTF-1 antibody (x200). (C) Immunohistochemical examination revealed that tumor cells were positive for monoclonal anti-Napsin A antibody (x200).
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A pathologic diagnosis of adenocarcinoma cells was established based on a bronchoscopic biopsy (Figure 1).
Amplification plot of EML4-ALK-positive by amplification refractory mutation system method.
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Tumor tissue was shown to be wild-type of epidermal growth factor receptor variants by ARMS (AmoyDx, Xiamen, People's Republic of China), and EML4-ALK fusion was shown by reverse transcription polymerase chain reaction (RT-PCR; AmoyDx; Figure 2). The patient received five cycles of first-line chemotherapy with cisplatin and paclitaxel from October 2012 to January 2013. The best tumor response was a partial response according to RECIST criteria, and the progression-free survival (PFS) was 7.0 months.
Hematoxylin-eosin staining and immunohistochemistry in small-cell cancer after crizotinib treatment.. Notes: (A) Hematoxylin-eosin staining revealed that tumor cells were lung small-cell cancer (x100). (B) Immunohistochemical examination revealed that tumor cells were positive for monoclonal anti-CD56 antibody (x100). (C) Immunohistochemical examination revealed that tumor cells were positive for monoclonal anti-Syn antibody (x200). (D) Immunohistochemical examination revealed that the tumor cell proliferation index was 98% for monoclonal anti-Ki-67 antibody (x100). (E) Immunohistochemical examination revealed that tumor cells were negative for monoclonal anti-CgA antibody (x100). (F) Immunohistochemical examination revealed that tumor cells were negative for monoclonal anti-PD-L1 antibody (x100).
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Histologic examination of the biopsy specimen revealed SCLC without adenocarcinoma components (Figure 3). IHC analysis demonstrated positivity for Syn and CD56, negativity for CgA, and a Ki-67 index of 98% (Figure 3).