P63-negative pulmonary NUT carcinoma arising in the elderly: a case report
- PDF / 1,644,299 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 23 Downloads / 164 Views
CASE REPORT
Open Access
P63-negative pulmonary NUT carcinoma arising in the elderly: a case report Satoe Numakura1,2* , Koji Saito1*, Noriko Motoi3, Taisuke Mori3, Yuichi Saito4, Fumi Yokote4, Yasuyuki Kanamoto4, Momoko Asami4, Takashi Sakai4, Yoshikane Yamauchi4, Yukinori Sakao4, Hiroshi Uozaki1,2 and Masafumi Kawamura4
Abstract Background: Pulmonary NUT carcinoma is rare, but lethal, thus, must not be overlooked. The definitive diagnosis is made by a NUT monoclonal antibody or gene analysis, but these are not always routinely available. Therefore, the diagnosis depends on this rare disease being suspected from the clinical and pathological findings. Generally, NUT carcinoma of the lung occurs near the hilum in younger adults with severe subjective symptoms. Histologically, it is characterized by the monomorphic growth of small cells which showed positivity of p63 immunohistochemistry. Case presentation: An 82-year-old man was referred for an incidental finding of an abnormal shadow at the peripheral apex of the right lung on computed tomography for a regular follow-up examination of renal cancer. Microscopically, small cell carcinoma was initially suspected; however, immunohistochemistry was not typical. NUT carcinoma with BRD4-NUT fusion was ultimately diagnosed using a NUT monoclonal antibody, fluorescence in situ hybridization, and RNA-seq. p63 and p40 protein expression was not detected. Conclusions: This is the first case of pulmonary NUT carcinoma to show negativity for p63 and is the oldest among previously reported cases. The present case suggests that NUT carcinoma should be suspected when the morphology of monomorphic growth of small cells without lineage-specific differentiation, regardless of age, clinical symptoms, the tumor location, or p63 expression. Keywords: NUT carcinoma, Lung, NUT immunohistochemistry, p63, Case report
Background NUT midline carcinoma is rare, but lethal. It was initially considered to occur in the midline organs (the mediastinum and upper aerodigestive tract) of children or adolescents [1]. However, with the recognition of NUT midline carcinoma and emergence of novel NUT monoclonal antibodies, case numbers are now increasing in all ages and organs, including extra-midline sites (resulting in the name NUT carcinoma) [2]. The International NUT Midline carcinoma registry (www. * Correspondence: [email protected]; [email protected] 1 Department of Pathology, Teikyo University Hospital, Tokyo, Japan Full list of author information is available at the end of the article
nmcregistry.org) [3] was established in 2010 for the purpose of obtaining more information on this disease [4]. Therefore, there is an ever-increasing need to recognize this disease in all specialties. NUT carcinoma is genetically defined and characterized by chromosomal rearrangements in the NUT gene. Its prognosis is poor regardless of the tumor site. There are currently no standard treatments and most cases are resistant to treatment; however, new therapeutic agents (histone deacetylase o
Data Loading...
