• Internal medicine · Jul 2024

    Metastatic Pleomorphic Carcinoma of the Lung with Extensive Chromosomal Rearrangements: An Autopsy Case with a Literature Review.

    • Fukuko Matsumoto, Michiko Matsuzawa Adachi, Katsuyuki Yoshida, Takeshi Yamashita, Jun Shiihara, Takahiko Fukuchi, Haruka Morikawa, Masahiko Hiruta, Keisuke Tanno, Noriko Oyama-Manabe, Hisashi Oshiro, and Hitoshi Sugawara.
    • Division of General Medicine, Department of Comprehensive Medicine 1, Jichi Medical University, Saitama Medical Center, Japan.
    • Intern. Med. 2024 Jul 4.

    AbstractWe herein report a 47-year-old man who presented with progressive paraparesis. Imaging revealed a right upper pulmonary nodule, massive bilateral adrenal metastases, thoracolumbar vertebral osteolysis, and subcutaneous nodules. A biopsy of the right buttock nodule revealed a poorly differentiated metastatic carcinoma with high programmed cell death-ligand 1 expression and extensive chromosomal rearrangements. The patient died 10 days after the initiation of pembrolizumab treatment. Autopsy findings confirmed pulmonary pleomorphic carcinoma with extensive metastases. Quantification of chromosomal rearrangements revealed a jump-up mutation from the normal karyotype, followed by a further incremental increase in the degree of deviation.

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