Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma

Chang, Yih‐Leong; Lee, Yung-Chie; Shih, Jin‐Yuan; Wu, Chen-Tu

doi:10.1016/s0169-5002(01)00224-0

Cited by 194 publications

(178 citation statements)

References 24 publications

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“…1,5 Several previous studies, in which a relatively large number of patients were analyzed, have reported that lymphatic metastasis was associated with a poor prognosis. 5 This study also indicated that lymphatic metastasis was an important factor that determined the prognosis of pulmonary pleomorphic carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…1 Before 1999, pulmonary pleomorphic carcinoma was considered a variant of other types of lung cancer because of its specific clinical manifestations, complex pathological tissues, and clinically indefinite characteristics. Because of the lack of a conclusive definition and the rarity of pulmonary pleomorphic carcinoma, no consensus has been reached regarding its diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment for pulmonary pleomorphic carcinoma: A retrospective study of 60 patients

Zhong

Fang

et al. 2014

Thoracic Cancer

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Background: Pleomorphic carcinoma is a rare epithelial malignant tumor. Because the clinical characteristics and behavior of the disease remain unclear, we investigated the clinicopathological findings and prognosis of 60 patients with pleomorphic carcinoma. Methods: The clinicopathological characteristics of 60 cases of pulmonary pleomorphic carcinoma identified between 1999 and 2011 were studied. Of these, 55 patients had peripheral disease and five had central disease. The tumor size in all patients was 1-9.5 cm (mean, 5.8 ± 4.5 cm), while 30 had lesions with a diameter larger than 5 cm. All patients underwent pulmonary resection. Results: There were no in-hospital deaths. The three and five year survival rates of all patients were 47.2% and 25.6%, respectively. The three and five year survival rates were 57.3% and 32.5% for N0 patients, and 25.4% and 17.1% for N1-2 patients, respectively. Overall survival was significantly different between the radical resection and incomplete resection groups. Multivariate Cox regression analyses of overall survival for all 60 patients indicated that radical resection (P = 0.041), tumor node metastasis (TNM) stage (P = 0.044), and nodal status (P = 0.029) were significant independent prognostic factors. Conclusion: Pleomorphic carcinoma is a rare type of lung cancer. In our study, pleomorphic carcinoma of the lung was often found as a peripherally located large mass and was associated with a poor prognosis. Radical resection, TNM stage and nodal status were significant independent prognostic factors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical treatment for pulmonary pleomorphic carcinoma: A retrospective study of 60 patients

Zhong

Fang

et al. 2014

Thoracic Cancer

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“…Similar to other types of lung carcinoma, sarcomatoid carcinoma tends to affect older patients with a history of tobacco smoking, and a male predominance has been observed. 2,3,5,6,9,10 Treatment is the same as for other lung carcinoma with non-small cell morphology, but sarcomatoid carcinoma tends to have a poor prognosis even in early-stage disease. 8 Substantial advancements in the treatment of lung cancer have occurred during the past decade, predominantly in adenocarcinomas.…”

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confidence: 99%

Molecular characterization of pulmonary sarcomatoid carcinoma: analysis of 33 cases

Terra

Jang

et al. 2016

Modern Pathology

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“…These tumors have been variously designated in the past as biphasic and monophasic sarcomatoid carcinoma, pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, pseudosarcoma, pulmonary blastoma and carcinosarcoma. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The latest recommendations of the World Health Organization have eliminated most of these terms, 1 confirming the designation of pleomorphic carcinomas to either pure neoplasms consisting of sarcomatoid spindle and giant tumor cells or biphasic neoplasms containing sarcomatoid spindle and/or giant cell components (accounting for at least 10% of the tumor mass) and conventional non-small-cell lung carcinoma, including squamous cell carcinoma, adenocarcinoma or large-cell carcinoma. These tumors may be differentiated from carcinosarcomas for the lack of a true malignant heterologous mesenchymal component, such as bone, cartilage, vessels or skeletal muscle, 10 and from pulmonary blastomas for the lack of primitive mesenchymal and epithelial tumor cells.…”

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confidence: 99%

K-ras gene mutational analysis supports a monoclonal origin of biphasic pleomorphic carcinoma of the lung

et al. 2004

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We investigated 27 pleomorphic carcinomas of the lung for exon 1 K-ras gene mutations using polymerase chain reaction-single-strand conformation polymophism analysis and direct sequencing. All pleomorphic carcinomas were biphasic, that is, composed of an adeno-, squamous-or large-cell-carcinomatous component associated with a spindle-and/or giant-cell component. Of 27 cases, six (22%) showed K-ras codon 12 mutations, which is a figure higher than that previously reported on in pure sarcoma-like pleomorphic carcinomas. Five tumors displayed the same mutation in both the epithelial and the sarcomatoid components, whereas in one tumor the mutation was restricted to the epithelial component. All mutations occurred in smokers, and were transversions, including GGT (glycine) to TGT (cysteine) change in two cases, to GCT (alanine) in two and to GTT (valine) in two. No significant relationships were found between the occurrence and type of mutations and patients' survival or any other clinicopathological variable, suggesting that K-ras mutations are early events in the development of these tumors. Our results indicate that most, though not all, biphasic pleomorphic carcinomas of the lung are monoclonal in origin, and that cigarette smoking may have a causative role in the development of K-ras alterations in these tumors, as all mutations are transversions.

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Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma

Cited by 194 publications

References 24 publications

Surgical treatment for pulmonary pleomorphic carcinoma: A retrospective study of 60 patients

Surgical treatment for pulmonary pleomorphic carcinoma: A retrospective study of 60 patients

Molecular characterization of pulmonary sarcomatoid carcinoma: analysis of 33 cases

K-ras gene mutational analysis supports a monoclonal origin of biphasic pleomorphic carcinoma of the lung

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