case_images: PMC8488083_01
case_images: Lung adenocarcinoma shown by radiologic and pathologic examinations. (A) Chest CT scan reveals a mass in right lung. (B) Hematoxylin and eosin staining shows a low differentiation adenocarcinoma (HE x 100).
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case_images: PMC8488083_01_fmed-08-649177-g0001.jpg
case_images: F1
case_images: The chest computed tomography (CT) showed a mass in the right lung (7.6 cm x 5.8 cm) with multiple enlarged lymph nodes in mediastinum (Figures 1A, 2). Percutaneous lung biopsy was performed, and atypical cells were observed (Figure 1B).
case_images: Timeline of diagnosis and treatment of the patient, with CT and MRI scans of lesions during the treatment of crizotinib additionally provided.
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case_images: PMC8488083_01_fmed-08-649177-g0002.jpg
case_images: F2
case_images: The chest computed tomography (CT) showed a mass in the right lung (7.6 cm x 5.8 cm) with multiple enlarged lymph nodes in mediastinum (Figures 1A, 2). Tumors v1.1. The follow-up CT examinations at 5 and 7 months after treatment showed that the lung lesion was stable compared with previous examinations (Figure 2). The MRI revealed an iso-signal shadow with a diameter of 0.8 cm and 2.1 cm in the right frontal lobe and parietal lobe, respectively, suggesting metastatic lesions in the brain (Figure 2).
case_images: (A) Sequencing reads of SDC4 and ROS1 are shown by the Integrative Genomics Viewer, and Schematic representation of the SDC4- ROS1 fusion protein domain structure. (B) The Integrative Genomics Viewer snapshot of ROS1-GK fusion. Schematic representation of the ROS1-GK fusion protein domain structure. Orange, SDC4; blue, ROS1; blue, ROS1; cyan, ADGRG6.
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case_images: PMC8488083_01_fmed-08-649177-g0003.jpg
case_images: F3
case_images: A total of five somatic mutations were detected (Table 1), including SDC4-ROS1(EX2:EX32) and ROS1-GK (EX31:EX13) double ROS1 rearrangements with mutant allele frequency of 7.0 and 7.8%, respectively (Figure 3).