PMC10160359_01
Pathological and immunohistochemical examination results. (A) hematoxylin-eosin staining(HE), magnification x40; (B) HE, mangnificationx100; (C) HE; magnificationx200; (D) Calretinin positivity, magnificationx200; (E) VIM positivity, magnificationx200;(F) WTI positivity, magnificationx200; (G) CK5/6 positivity, magnificationx200; (H) PCK positivity, magnificationx200; (I) CEA negativity, magnificationx200.
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Immunohistochemistry showed that it was positive for Calretinin, VIM, WT1, PAX8, mesothelin, CK5/6, PCK, CK7, MLH1, PMS2, MSH2, MSH6, weakly positive for BAP1, while being negative for Napsin A, P504S, CEA, D2-40, GATA3 ( Figure 1 ).
(A) identification of the STRN-ALK fusion; (B) identification of the NBEA-ALK fusion.
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Illumina NovaSeq 6000 platform (Illumina, San Diego, CA). The sequencing analysis identified STRN-ALK (intron3:intron19) and NBEA-ALK (intron1:intron16) double-ALK fusion ( Figure 2 ).
Timeline of clinical events.
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The treatment timeline of this patient is illustrated in  Figure 3 .