BRAF-Mutant Pulmonary Langerhans Cell Histiocytosis Mimicking Recurrence of Early-Stage KRAS-Mutant Lung Adenocarcinoma

Alden, Stephanie L.; Swanson, Scott J.; Nishino, Mizuki; Sholl, Lynette M.; Awad, Mark M.

doi:10.1016/j.jtocrr.2020.100127

Cited by 2 publications

(8 citation statements)

References 5 publications

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“…A review of the literature revealed two cases [9,10] of lung adenocarcinoma associated with LCH in which molecular analysis of both diseases was performed. There were two smoking women (45-and 56-year-old) with an adenocarcinoma harboring KRAS mutation (p.G12D) and concomitant BRAF V600E mutated LCH, while the other case had BRAF p.V600E mutation in the adenocarcinoma and wild-type LCH.…”

Section: Resultsmentioning

confidence: 99%

“…Pulmonary Langerhans cell histiocytosis (PLCH) is a diffuse, smoking-related interstitial lung disease generally presenting with nodules and/or cysts mainly involving the upper lobes [1]. Some reports have described the synchronous occurrence of lung adenocarcinoma and LCH, hypothesizing that scarring fibrosis generated by long-standing PLCH may increase the risk of developing lung carcinoma [2][3][4][5][6][7][8][9][10][11]. In the study by Sadoun et al [5] the average time of cancer occurrence from LCH was 10.5 years, while patients with lung cancer and LCH were significantly older than those with only PLCH (64.7 years vs. 40.8 years, p < 0.01).…”

Section: Introductionmentioning

confidence: 99%

“…In the study by Sadoun et al [5] the average time of cancer occurrence from LCH was 10.5 years, while patients with lung cancer and LCH were significantly older than those with only PLCH (64.7 years vs. 40.8 years, p < 0.01). Nevertheless, smoking has the key role in promoting both PLCH and lung cancer [2][3][4][5][6][7][8][9][10][11]. More recently, PLCH has been regarded as a clonal, neoplastic process of peculiar histiocytes (Langerhans cells) co-expressing S100 protein, CD1a and Langerin [12], as confirmed in the last World Health Organization classification of thoracic tumors [13].…”

Section: Introductionmentioning

confidence: 99%

“…Among PLCH-associated lung adenocarcinoma analyzed at the molecular level, Kalchiem-Dekel et al [9] and Alden et al [10] described PLCH discovered on surveillance imaging in patients with pre-existing lung adenocarcinoma. In one case the authors demonstrated BRAF p.V600E mutation in adenocarcinoma, but not in PLCH [9], while BRAF-V600E-mutant PLCH coexisting with KRAS-mutant adenocarcinoma was noted in the other case [10].…”

Section: Introductionmentioning

confidence: 99%

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Langerhans Cell Histiocytosis-Associated Pulmonary Adenocarcinoma: A Word of Caution during Molecular Determinations

Melocchi

Mondoni

Malapelle

et al. 2022

JMP

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Background: Smoking habit is a common cause of pulmonary Langerhans cell histiocytosis (PLCH) and lung cancer and both diseases may coexist in the lung and share genetic alterations, such as V600E BRAF mutations. We collected a small series of three cases of PLCH-associated lung adenocarcinoma in order to evaluate the molecular setup in both components and underline the critical role of careful tissue selection for predictive molecular driver testing. Methods: Three cases of PLCH-associated adenocarcinoma were collected from consultation files. Clinical data from referring physicians and clinical data were obtained. The surgical biopsies were tested by immunohistochemistry and molecular analysis after separate dissection of adenocarcinoma cells and Langerhans histiocytes. Results: There were three active smoking men with a median age at diagnosis of 60.6 years. PLCH was disclosed at imaging during work-up for suspected lung cancer. Molecular analysis revealed KRAS (G12C and G13C) mutations in two cases and V600E BRAF mutation in one case of PLCH. Immunostaining with the V600E BRAF mutation specific primary antibody VE1 correctly recognized BRAF-mutated LCH. One case was wild-type in both diseases. Two similar cases were found in the literature, one of which showed a discrepant KRAS (G12D) mutation in adenocarcinoma and a V600E BRAF mutation in LCH; Conclusions: This case series of PLCH-associated adenocarcinoma underline the possibility to disclose identical genetic alterations in co-existing benign and malignant pathologies, then potentially creating erroneous interpretation of molecular analysis leading to inadequate therapeutic options in case of incorrect diagnostic recognition and inappropriate selection of both components through microdissection.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Langerhans Cell Histiocytosis-Associated Pulmonary Adenocarcinoma: A Word of Caution during Molecular Determinations

Melocchi

Mondoni

Malapelle

et al. 2022

JMP

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“…Alden et al [ 15 ] describe a patient suffering from early-stage lung adenocarcinoma who developed bilateral pulmonary nodules in the case report. Histopathologic examination revealed Langerhans cell histiocytosis, positive for CD1a, Langerin, and S100 and genomic sequencing identified a BRAF V600E mutation.…”

Section: Discussionmentioning

confidence: 99%

Two smoking-related lesions in the same pulmonary lobe of squamous cell carcinoma and pulmonary Langerhans cell histiocytosis: A case report

Gencer¹,

Ozcibik²,

Karakas³

et al. 2022

WJCC

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BACKGROUND Pulmonary Langerhans cell histiocytosis (PLCH) is a rare cystic lung disease usually affecting young adults. It is predicted that PLCH is a lung tumor precursor associated with dysfunction of the myeloid dendritic cells in the lung. CASE SUMMARY A 70-year-old male patient presented with chronic cough and sputum. He had symptoms for 5 years and described shortness of breath on exertion for the previous 3 years. He had a 60 packs/year smoking history. Computerized tomography of the thorax revealed an 11-mm nodule in the right lung lower lobe superior segment and a 7-mm nodule in the right lung lower lobe poster basal segment. Those two nodules were resected by means of right thoracoscopic surgery. Pathological evaluation revealed a squamous cell carcinoma and PLCH. CONCLUSION Coexistent squamous cell carcinoma and PLCH suggest possible association between PLCH and lung cancer.

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BRAF-Mutant Pulmonary Langerhans Cell Histiocytosis Mimicking Recurrence of Early-Stage KRAS-Mutant Lung Adenocarcinoma

Cited by 2 publications

References 5 publications

Langerhans Cell Histiocytosis-Associated Pulmonary Adenocarcinoma: A Word of Caution during Molecular Determinations

Langerhans Cell Histiocytosis-Associated Pulmonary Adenocarcinoma: A Word of Caution during Molecular Determinations

Two smoking-related lesions in the same pulmonary lobe of squamous cell carcinoma and pulmonary Langerhans cell histiocytosis: A case report

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