J Pathol Transl Med.  2021 Jan;55(1):79-82. 10.4132/jptm.2020.11.02.

EGFR-mutated pulmonary adenocarcinoma with concurrent PIK3CA mutation, and with acquired RET fusion and EGFR T790M mutation after afatinib therapy

• Kim M
• Na JM
• Lee GW
• Lee SJ
• Kim JD
• Yang JW

• KMID: 2511517
• DOI: http://doi.org/10.4132/jptm.2020.11.02

Figure

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  Fig. 1 Clinical course and pathological diagnosis of the patient. Adenocarcinoma was diagnosed using pleural fluid (A), and lung needle biopsy (B). Lung wedge resection specimen showed tumor heterogeneity; solid and cribriform components (C), and acinar and papillary components (D). (E) Metastatic adenocarcinoma was observed in the axillary LN. EGFR, epidermal growth factor receptor; PIK3CA, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha; NGS, next-generation sequencing; RT-PCR, reverse tranascription; LN, lymph node.

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  Fig. 2 Chest computed tomography. (A) Lung mass (arrow) in right upper lobe with pleural fluid (arrowhead) at diagnosis. (B) Decreased size of lung mass (arrow) and amount of pleural fluid (arrowhead) after 3 months of afatinib therapy. (C) Increased amount of pleural fluid (arrow) after 7.5 months with afatinib therapy. (D) Increased size of axillary (arrow) and mediastinal (arrowhead) lymph nodes after 3 months with osimertinib therapy.

Reference

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