ALK alterations in salivary gland carcinomas

Virchows Arch. 2021 May;478(5):933-941. doi: 10.1007/s00428-020-02971-w. Epub 2020 Nov 25.


Salivary gland carcinomas represent a heterogeneous group of poorly characterized head and neck tumors. The purpose of this study was to evaluate ALK gene and protein aberrations in a large, well-characterized cohort of these tumors. A total of 182 salivary gland carcinomas were tested for anaplastic lymphoma kinase (ALK) positivity by immunohistochemistry (IHC) using the cut-off of 10% positive cells. ALK positive tumors were subjected to FISH analysis and followed by hybrid capture-based next generation sequencing (NGS). Of the 182 tumors, 8 were ALK positive by IHC. Further analysis using hybrid capture NGS analysis revealed a novel MYO18A (Exon1-40)-ALK (exon 20-29) gene fusion in one case of intraductal carcinoma. Additional genomic analyses resulted in the detection of inactivating mutations in BRAF and TP53, as well as amplifications of ERBB2 and ALK. ALK rearrangements are a rare entity in salivary gland carcinomas. We identified a potentially targetable novel ALK fusion in an intraductal carcinoma of minor salivary glands.

Keywords: Anaplastic lymphoma kinase; FISH; Immunohistochemistry; Intraductal carcinoma; Next generation sequencing; Salivary gland carcinoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anaplastic Lymphoma Kinase / genetics*
  • Biomarkers, Tumor / genetics*
  • Carcinoma / enzymology
  • Carcinoma / genetics*
  • Carcinoma / pathology
  • Carcinoma, Intraductal, Noninfiltrating / enzymology
  • Carcinoma, Intraductal, Noninfiltrating / genetics
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Child
  • Female
  • Gene Amplification
  • Gene Fusion
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Male
  • Middle Aged
  • Salivary Gland Neoplasms / enzymology
  • Salivary Gland Neoplasms / genetics*
  • Salivary Gland Neoplasms / pathology
  • Young Adult


  • Biomarkers, Tumor
  • ALK protein, human
  • Anaplastic Lymphoma Kinase