Pathological examination of liver puncture biopsy with immunohistochemistry TTF-1(+), NapsinA(+), CK7(+), CDX-2(−), villin(−), CK20(−), HepPar-1(−), CK19(foci +), Ki-67(+, 40%), CD10(−), combined with medical history and immunohistochemistry, supported liver metastasis from lung adenocarcinoma (Figs. 1c, 3a). This evidence concerns the gene MKI67 and lung adenocarcinoma.