A 29-year-old man developed a persistent dry cough. Chest high-resolution computed tomography (HRCT) revealed centrilobular ultrafine granular shadows scattered in all lung fields. A lung biopsy with videoassisted thoracoscopic surgery revealed findings compatible with pulmonary tumor thrombotic microangiopathy (PTTM). However, the primary tumor was not identified. Combination chemotherapy with S-1 and cisplatin decreased his cough and improved the chest HRCT findings. The illness, however, gradually became difficult to control. He eventually developed pulmonary hypertension and died. Typically, an antemortem diagnosis of PTTM cannot be made. In this case, the diagnosis of PTTM and combination chemotherapy improved the chest HRCT findings, respiratory symptoms, and prognosis.

These findings suggest that the Tyr kinase/JNK pathway may play a role in bronchial smooth muscle contraction. Strategies to inhibit JNK activation may represent a novel therapeutic approach for diseases involving airway obstruction, such as asthma and chronic obstructive pulmonary disease.

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We compared performance of the assay between two laboratories, finding a high rate of concordance and reproducibility. Using DNA quantities typical of those found in up to 4ml of plasma from cancer patients, our assay provides high sensitivity for variants that are present at allele fraction 0.25% or higher in plasma, and retains substantial sensitivity at allele fractions as low as 0.1%. Standard dilution curves of well-characterized reference samples show that the accuracy of the eTAm-Seq ® assay is predominantly limited by stochastic sampling. Analysis of plasma samples from control individuals demonstrates a low false positive rate. Additional data with associated clinical data will be presented at the meeting. Conclusion: Our data demonstrates eTAm-Seq TM assy's robustness and performance in two labs, supporting its use as a basis for clinical applications globally, allowing a high degree of standardization and comparability for molecular profiling of tumors using liquid biopsy.