P10: Coexisting pulmonary adenocarcinoma and Langerhans cell histiocytosis/hyperplasia: a rare association in a non-smoking woman

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ID Serval
serval:BIB_E59D88E71AE0
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Poster: résume de manière illustrée et sur une page unique les résultats d'un projet de recherche. Les résumés de poster doivent être entrés sous "Abstract" et non "Poster".
Collection
Publications
Titre
P10: Coexisting pulmonary adenocarcinoma and Langerhans cell histiocytosis/hyperplasia: a rare association in a non-smoking woman
Titre de la conférence
Swiss Pathology Days
Auteur(s)
Maillard M., Vijigen S., Beigelman C., Letovanec I.
Adresse
Thun, Switzerland, November 10-12, 2017
ISSN
0172-8113
1432-1963
ISSN-L
1432-1963
Statut éditorial
Publié
Date de publication
20/12/2017
Volume
38
Numéro
6
Série
Der Pathologe
Pages
576
Langue
anglais
Résumé
Background: Adenocarcinoma is the most common type of lung cancer
with a specific molecular landscape and EGFR mutations accounting
for 10–20% of driver mutations. Langerhans cell histiocytosis (LCH) is a
chronic interstitial lung disease usually found in young adults and strongly
associated with smoking, with a high prevalence of BRAF (35–50%)
and NRAS(10–15%) mutation. The association of these two diseases is
rare with exceptional cases reported, especially in non-smoking patients.
Methods: We report the case of a 50 years-old non-smoking woman who
presented with multiple lung lesions on CT-scan (5 cm mass in the upper
right lobe, satellite nodules in the two other ipsilateral lobes and pleural
metastasis). Biopsies of the upper lobe mass and of a pleural lesion were
performed. The following immunomarkers were tested: TTF1, Napsin,
S100, CD1a and Langerin. Furthermore, gene sequencing was performed
in order to detect EGFR and BRAF mutations.
Results: H&E slides revealed and unexpected finding: the association of
lung adenocarcinoma (TTF1+ and Napsin+) with Langerhans cell histiocytosis/hyperplasia
(S100+, CD1a+, Langerin+). Molecular study revealed
EGFR mutation (c.2573T>G (p.L858R), exon 21) in the adenocarcinoma.
No BRAF mutation was found.
Conclusions: This is the first reported case of lung adenocarcinoma admixed
with Langerhans cell histiocytosis/hyperplasia in a non-smoking patient.
As no BRAF mutation was identified and the same association of adenocarcinoma
and Langerhans cell was present in both biopsies, we hypothesize
that the Langerhans cell proliferation was “reactive” in nature, rather
than neoplastic. Furthermore, after anti-EGFR therapy, most of the nodules
present on CT-scan regressed and no typical CT-image of LCH was present.
Création de la notice
13/11/2017 15:21
Dernière modification de la notice
20/08/2019 17:08
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