case_images: PMC10753796_01
case_images: Bronchoscopic view of the patient. (A) Bronchoscopic view at the carinal level, illustrating obstructive masses within the bilateral bronchi and the left main bronchus.(B) After the apply of bronchoscopy electrocautery for central airway obstruction.(C) Two months following the commencement of alectinib treatment.
case_images: fgene-14-1289346-g001.jpg
case_images: PMC10753796_01_fgene-14-1289346-g001.jpg
case_images: F1
case_images: Diagnostic bronchoscopy revealed an uneven and congestive polypoid mass with luminal obstruction of the right principal bronchus, electrocautery based on bronchoscopy was applied for central airway obstruction (Figures 1A, B). These promising clinical responses were consistently observed in subsequent follow-up assessments (Figures 1C, 4).
case_images: CT scan and lung biopsies of the reported patient. (A) CT findings of the patient (B)HE staining of the biopsy specimen, 40x. (C) Immunohistochemical staining for Napsin A. (D) Immunohistochemical staining for thyroid transcription factor-1 (TTF-1).
case_images: fgene-14-1289346-g002.jpg
case_images: PMC10753796_01_fgene-14-1289346-g002.jpg
case_images: F2
case_images: Chest CT and pathological examination of a bronchoscopic biopsy showed poorly differentiated invasive adenocarcinoma. (Figures 2A, B). Immunohistochemical (IHC) analysis revealed positive staining for Napsin A and thyroid transcription factor 1 (TTF1) which have been widely used as sensitive markers of pulmonary adenocarcinoma (2) (Figures 2C, D).
case_images: Identification of the KIF13A-ALK fusion (A)
  KIF13A-ALK fusion was validated manually using the Integrated Genomics Viewer; (B) A novel intergenic region between exons 1-18 of KIF13A on chromosome 6 and exons 20-29 of ALK on chromosome 2 fusion variant was identified. (C) Validation of ALK expression via IHC staining (40x), (D) Fluorescence in situ hybridization (FISH) analysis utilizing the ALK split apart probe, demonstrating distinct split signals (indicated by arrows) suggestive of a rearrangement of the ALK gene.
case_images: fgene-14-1289346-g003.jpg
case_images: PMC10753796_01_fgene-14-1289346-g003.jpg
case_images: F3
case_images: This fusion encompassed exons 1-18 of KIF13A on chromosome 6 and exons 20-29 of ALK on chromosome 3 (Figures 3A, B). Furthermore, immunocytochemistry (IHC) and fluorescence in situ hybridization (FISH) were also performed to verify the above mutation (Figures 3C, D).
case_images: CT Imaging of the reported patients with follow-up.
case_images: fgene-14-1289346-g004.jpg
case_images: PMC10753796_01_fgene-14-1289346-g004.jpg
case_images: F4
case_images: These promising clinical responses were consistently observed in subsequent follow-up assessments (Figures 1C, 4).