Novel Pattern of Nuclear Staining With ROS1 Immunohistochemistry: A Case Report.

Q4 Medicine

Case Reports in Pulmonology Pub Date : 2026-06-02 eCollection Date: 2026-01-01 DOI:10.1155/crpu/2900967

Diane M Wilcock, Deepika Sirohi, Kristina Moore, Allie H Grossmann, Georgios Deftereos

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Abstract

ROS1 rearrangements are driver events in a subset of nonsmall cell lung carcinomas and may qualify patients for ROS1-directed treatment. ROS1 immunohistochemistry (IHC) is often used for screening of lung carcinomas for ROS1 gene rearrangement and has a cytoplasmic and/or membranous staining pattern. Here, we report an unusual case of a lung adenocarcinoma displaying a strong nuclear staining pattern on ROS1 IHC. ROS1 fluorescence in situ hybridization (FISH) reflex testing was ordered. ROS1 FISH testing showed an isolated 3 ^' signal pattern, indicating a potential rearrangement or deletion in the ROS1 gene. Next-generation sequencing (NGS) analysis revealed a NMP1::ROS1 rearrangement. The tumor was from a 74-year-old male with a previous history of lung squamous cell carcinoma. This new occurrence was determined to be a lung adenocarcinoma and displayed papillary features, whereas concurrent lymphadenopathy was also present. Immunostaining for ALK was negative, and there was no expression of PD-L1 22C3 IHC. This case report highlights an unexpected ROS1 IHC staining associated with a rare ROS1 gene rearrangement.

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新的ROS1免疫组化核染色模式：1例报告。

ROS1重排是非小细胞肺癌亚群的驱动事件，可能使患者有资格接受ROS1定向治疗。ROS1免疫组织化学（IHC）常用于筛查肺癌的ROS1基因重排，并有细胞质和/或膜染色模式。在此，我们报告一例罕见的肺腺癌，在ROS1免疫组化上显示强烈的核染色模式。责令ROS1荧光原位杂交（FISH）反射检测。ROS1 FISH检测显示一个分离的3 '信号模式，表明ROS1基因可能存在重排或缺失。下一代测序（NGS）分析显示NMP1::ROS1重排。患者为74岁男性，既往有肺鳞状细胞癌病史。这个新发生的病例被确定为肺腺癌，并表现出乳头状特征，同时也存在淋巴结病。ALK免疫染色阴性，免疫组化未见PD-L1 22C3表达。本病例报告强调了与罕见的ROS1基因重排相关的意想不到的ROS1 IHC染色。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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