SMARCA4-deficient non-small cell carcinoma of the lung

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SMARCA4-deficient non-small cell carcinoma of the lung is an emerging subtype of lung cancer.[1]


  • ~5.1% of non-small cell carcinoma is SMARCA4 deficient in a series of 316 cases.[2]
  • May represent or overlap with what is known as hepatoid adenocarcinoma of the lung.[citation needed]
  • The main differential diagnosis is metastatic adenocarcinoma.



  • CK7 +ve.
  • TTF-1 -ve.
  • HepPar-1 +ve (15/20 +ve, 2/20 isolated +ve cells, 3/20 -ve).[1]
  • SMARCA4 -ve.
  • Napsin A -ve (1/28 +ve).[3]


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The tumour stains as follows: 
POSITIVE: CK7 (diffuse, strong), HepPar-1 (strong, diffuse).
NEGATIVE: TTF-1, napsin A, p63, CK5/6.

The staining pattern for this tumour is not typical for lung adenocarcinoma; please correlate with the clinical findings.

HepPar-1 POSITIVITY with CK7 POSITIVITY and TTF-1 NEGATIVITY may be seen in SMARCA4-deficient adenocarcinoma of the lung.[1]

1. Virchows Arch 471 (5): 599-609. doi:10.1007/s00428-017-2148-5. PMID 28555282.

See also


  1. 1.0 1.1 1.2 Agaimy, A.; Fuchs, F.; Moskalev, EA.; Sirbu, H.; Hartmann, A.; Haller, F. (Nov 2017). "SMARCA4-deficient pulmonary adenocarcinoma: clinicopathological, immunohistochemical, and molecular characteristics of a novel aggressive neoplasm with a consistent TTF1". Virchows Arch 471 (5): 599-609. doi:10.1007/s00428-017-2148-5. PMID 28555282.
  2. Herpel, E.; Rieker, RJ.; Dienemann, H.; Muley, T.; Meister, M.; Hartmann, A.; Warth, A.; Agaimy, A. (Feb 2017). "SMARCA4 and SMARCA2 deficiency in non-small cell lung cancer: immunohistochemical survey of 316 consecutive specimens.". Ann Diagn Pathol 26: 47-51. doi:10.1016/j.anndiagpath.2016.10.006. PMID 28038711.
  3. Sayeda S, Naqvi A, Begum H, Finley C, Coschi C, Juergens R, Bonert M. (August 2022). "34th European Congress of Pathology - Abstracts (Prevalence of TTF-1 negative lung adenocarcinoma on lung core biopsy with EGFR, ALK and PD-L1 status)". Virchows Arch 481 (Suppl 1): 1–364. doi:10.1007/s00428-022-03379-4. PMC 9379246. PMID 35972647.
  4. Haninger, DM.; Kloecker, GH.; Bousamra Ii, M.; Nowacki, MR.; Slone, SP. (Apr 2014). "Hepatoid adenocarcinoma of the lung: report of five cases and review of the literature.". Mod Pathol 27 (4): 535-42. doi:10.1038/modpathol.2013.170. PMID 24030743.