Complete response in anaplastic lymphoma kinase–rearranged oncocytic thyroid cancer: A case report and review of literature

Figure 1 Pathological findings of biopsies and ALK positive pictures. A: Fine needle aspiration of the thyroid lesion: Clusters of pleomorphic overlapping epithelial cells with abundant basophilic cytoplasm and atypical eccentric nucleus. Colloid not seen (May-Grünwald-Giemsa staining × 200); B: Supraclavicular lymph node biopsy: Sheets of malignant cells with eosinophilic cytoplasm and high grade atypia (Hematoxylin and eosin staining × 200); C: Lymph node metastasis: Moderate cytoplasmic staining for ALK immunohistochemistry (× 400); D: Biopsy of the breast mass: Malignant cells with oncocytic features involving breast parenchyma (Hematoxylin and eosin staining × 200); E: Biopsy of the breast mass: Strong cytoplasmic staining for ALK immunohistochemistry (× 400).

Figure 2 Comparison between baseline positron emission tomography scans (A, left) and after 4 mo of crizotinib treatment (B, right). A: Before treatment, thyroid, pulmonary, ganglion and bone hypermetabolic spots; B: Complete metabolic response with condensing bone metastases without significant hypermetabolism.

Figure 3 Timeline of the case history, treatment, and clinical outcome.