In:
American Journal of Surgical Pathology, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 7 ( 2020-07), p. 962-969
Abstract:
Secretory carcinoma (SC) of the salivary glands is a low-grade carcinoma characterized by a well-defined morphology and immunohistochemical features. ETV6-NTRK3 fusions are detected in the great majority of SCs. Recently, other partners fused to ETV6 have been documented in a small portion of SCs, suggesting the presence of alternative genetic fusion. In this study, we examined the genetic fusion of 9 SCs using fluorescence in situ hybridization, reverse transcription-polymerase chain reaction, and next-generation sequencing (ArcherDx). Classic ETV6 exon 5 -NTRK3 exon 15 fusion was detected in 8 of 9 SCs. The remaining tumor was negative for the ETV6-NTRK3 fusion but harbored a novel fusion, CTNNA1 exon 11 -ALK in exon 20. Immunohistochemically, pan-TRK was positive in 8 tumors with ETV6-NTRK3 fusion but negative in an ALK -rearranged SC, while ALK was positive only in the ALK -rearranged tumor. Histologically, the ALK -rearranged tumor showed dominant macrocystic architecture. In conclusion, we found a case of SC with CTNNA1-ALK fusion. Because ALK fusion after exon 20 on the ALK side (upstream of the tyrosine kinase domain) has been reported to activate a carcinogenic kinase in various ALK -rearranged tumors, ALK inhibitors may be a possible therapeutic option for ALK -rearranged SC. In addition, ALK immunohistochemistry can be a screening tool for ALK -rearranged SC. This study also expands the molecular spectrum of this tumor beyond the ETV6 gene.
Type of Medium:
Online Resource
ISSN:
0147-5185
DOI:
10.1097/PAS.0000000000001471
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2029143-7
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