The right upper lobe resection specimens:1. (right upper lobe)Central type invasive adenocarcinoma, part of acinar adenocarcinoma, a small part of micro papillary adenocarcinoma, a small part of solid adenocarcinoma, with pleural invasion; 2. No cancer tissue was found in bronchial stump; 3、Infiltrating adenocarcinoma cells were found in the diaphragm.4、Metastatic carcinoma was found in (Group 11) lymph node (3/ 7), (left laryngeal reflux）lymph node (1 / 2), (Group 7)lymph node, (3/ 8), (Group 9) lymph node (2 / 3) and (Group 10) lymph node (2 / 5).
CK7(++),TTF-1(++),NapsinA(++),CKH(++),ki-67(+, about 20%),P40（+,A few cells),P63(+),Vimentin(-),CK5/6(-),Syn(-),CgA(-),CD56(-).
The right upper lobectomy specimen: The volume is 12 * 9.5* 2.5cm. There were a grayish yellow mass 1cm away from the bronchial stump with the volume of 6.5 * 3.5 * 3cm. The section is grayish yellow and medium in quality. In addition, gray white nodules were found in diaphragmatic tissue with the volume of 2.5 *1.5 *1cm.
Gender：F
Age：57
family history ：Mother died for unknown reasons. Father is still alive
Serological examination ：Serum CEA was slightly higher and NSE was normal
surgical mode ：right upper lobectomy
Tumor size： 6.5 * 3.5 * 3cm
Disease status(primary/relapse)：primary
G：II-III
TNM：T4N3M1
Stage：IVA
Gene：ROS1
Mutant Site：PCR
Mutation Type：fusion
% tumor ：*
% necrosis：*
