Background: Pulmonary invasive mucinous adenocarcinoma (IMA) is a rare variant of lung adenocarcinoma that rarely shows anaplastic lymphoma kinase (ALK) rearrangement. Alectinib (tyrosine kinase inhibitors) has been listed as category 1 recommendations for advanced ALK + NSCLC first-line therapy due to low toxicity and excellent efficacy, and its median progression-free survival is 34.8 months. Here, we report a case of a patient with ALK-rearranged lung IMA who showed favorable results to neoadjuvant alectinib. Case: A 67-year-old man with no history of smoking was diagnosed with clinical stage as IIIB invasive mucinous adenocarcinoma based on clinical symptoms, chest CT and pathological findings. The anaplastic lymphoma kinase (ALK) fusion status was assessed by realtime PCR. After acquiring informed consent from the patient, we offered neoadjuvant alectinib at a dosage of 150 mg twice per day for three cycles (84 days), all lesions were undetectable on chest CT. Later, a thoracoscopic left lobectomy was performed. The postoperative pathological showed that a small amount of tumor cells remained, and the TNM stage was downstaged as T1aN0M0 IA. Conclusion: To our knowledge, this is the first case discussing the treatment of ALKrearranged IMA of the lung with neoadjuvant alectinib. Alectinib is an effective ALK inhibitor, and in cases of lung adenocarcinoma with ALK rearrangement, alectinib treatment is a reasonable and priority option. Neoadjuvant alectinib may be clinically feasible and well tolerated in locally advanced NSCLC.

Legionella pneumophila ( L. pneumophila ) is the most pathogenic species of Legionella , which can cause Legionella disease. It can cause pneumonia, or Pontiac fever. In severe cases, it can lead to respiratory failure and kidney failure, with a high fatality rate. Here, a novel molecular diagnosis method, a loop-mediated isothermal amplification coupled with lateral flow biosensor (LFB) method (LAMP-LFB) was successfully established and evaluated for the identification of L. pneumophila . A set of 6 primers was designed specifically based on the L. pneumophila -specific gene mip. The optimized time and temperature conditions for the LAMP was 50 min and 64◦C respectively. The minimum concentration that can be detected by this method was 100fg. Using the protocol, we could observe the LAMP amplification within 2min by LFB. The whole process, including the preparation of DNA (20 min), LAMP reaction (50 min) and results reporting (2 min), could be finished within 75 min. Among 50 alveolar lavage fluid samples, 5(10%) were L. pneumophila -positive by the LAMP-LFB, and the diagnostic accuracy was 100% when compared to the culture method. While only 4 samples were positive using PCR method. In a word, the LAMP-LFB assay is a rapid, sensitive and specific detection method that can detect Legionella pneumophila , and it can be used as a new molecular method for the detection of target pathogens in water, environmental and clinical samples.