ALK Is a Specific Diagnostic Marker for Inflammatory Myofibroblastic Tumor of the Uterus

The American Journal of Surgical Pathology
Nissreen MohammadCheng-Han Lee

Abstract

Inflammatory myofibroblastic tumor (IMT) is a myofibroblastic/fibroblastic neoplasm of intermediate malignant potential. It is frequently characterized by genetic fusion of ALK with a variety of partner genes, which results in the activated ALK signaling pathway that can be targeted with kinase inhibitors. IMTs can occur in the gynecologic tract, with the uterus (corpus and cervix) being the most frequent site. Recent studies suggest that IMTs in the gynecologic tract are underrecognized, and a low-threshold for performing ALK immunohistochemistry has been proposed. The aim of this study was to evaluate the specificity of ALK immunohistochemistry for IMTs among uterine mesenchymal and mixed epithelial/mesenchymal tumors. We performed ALK immunohistochemistry on 14 molecularly confirmed uterine IMTs and 260 other uterine pure mesenchymal and mixed epithelial/mesenchymal tumors. Cases showing any positive cytoplasmic and/or membranous staining of the tumor cells were considered to be ALK positive. All 14 IMTs were confirmed to harbor ALK genetic fusion by RNA sequencing, and ALK immunostaining in the form of granular cytoplasmic positivity with paranuclear accentuation was observed in all 14 cases. ALK was negative (complete abse...Continue Reading

References

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Citations

Mar 5, 2019·The American Journal of Surgical Pathology·Sarah ChiangCristina R Antonescu
Feb 12, 2019·International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists·Shabnam ZareiMaria Luisa C Policarpio-Nicolas
Dec 9, 2020·International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists·Carlos Parra-Herran
Apr 18, 2020·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Martee L HensleyDavid M Hyman
Aug 10, 2021·Biochimica Et Biophysica Acta. Reviews on Cancer·Fan TangXia-Wei Wei
Aug 16, 2021·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Patrick SchöffskiBernd Kasper

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