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A case of synchronous bilateral lung cancers: EML4-ALK positive adenocarcinoma in the right lung and adenocarcinoma in situ (the former bronchioloalveolar carcinoma) in the left lung

Ikuo Matsuda1, Kengo Takeuchi2, Shinjiro Mizuguchi3, Masahide Kaji3, Kayo Ueda4, Kazuhiro Teramura4 and Seiichi Hirota1*

Author Affiliations

1 Department of Surgical Pathology, Hyogo College of Medicine, Hyogo 663-8501, Japan

2 Pathology Project for Molecular Targets, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan

3 Department of Surgery, Yodogawa Christian Hospital, Osaka 533-0032, Japan

4 Department of Pathology, Yodogawa Christian Hospital, Osaka 533-0032, Japan

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BMC Pulmonary Medicine 2013, 13:25  doi:10.1186/1471-2466-13-25

Published: 25 April 2013



Recently it has been revealed that lung adenocarcinomas with distinct gene mutations or fusions are associated with particular histopathological entities. For example, epidermal growth factor receptor (EGFR) gene mutations are often associated with well differentiated adenocarcinoma of the lung with bronchioloalveolar pattern. On the other hand, echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) fusion gene in a subset of lung adenocarcinoma is related to mucinous cribriform histology.

Case presentation

Reported herein is a case of synchronous EML4-ALK positive lung adenocarcinoma and adenocarcinoma in situ in the bilateral lungs of a 55-year-old Japanese woman. The woman had EML4-ALK positive lung adenocarcinoma in the right lower lung while adenocarcinoma in situ in the left upper lung, which was EML4-ALK negative.


To our knowledge, this is the first report of synchronous, bilateral lung adenocarcinomas composed of EML4-ALK positive and negative ones.

EML4-ALK; Lung adenocarcinoma; Adenocarcinoma in situ