Pulmonary spindle cell carcinoma with unusual morphology

Abstract

Rationale:Pulmonary spindle cell carcinoma (PSCC) is a highly malignant carcinoma that often exhibits the histopathological characteristic of cell pleomorphism.Patient concerns:Here, we report a PSCC case in a 59-year-old woman with multiple metastases. The pathological manifestation of this case did not show high-grade pleomorphism or atypia, and was easily mimicked by other borderline or low-grade malignant tumors such as an inflammatory myofibroblastic tumor (IMT).Diagnoses:Based on the results of immunohistochemistry and fluorescence in situ hybridization after the operation, IMT was ruled out, and PSCC was confirmed.Interventions:Resection of the right middle lobe and dissection of the lymph nodes were performed. The patient was given 2 cycles of chemotherapy with cisplatin and 1 cycle of radiotherapy after the operation.Outcomes:Metastatic lesions in the left kidney, the right lung, the first thoracic vertebrae, the retroperitoneal lymph nodes, and the mediastinal lymph nodes were identified by positron emission tomography/computed tomography 4 months after the operation, and the patient died 2 months later.Lessons:PSCC is a highly malignant carcinoma, but it rarely shows a low-grade malignant histological morphology. So, efforts should be focused on differentiating it from other borderline or low malignant tumors (such as IMT) to avoid misdiagnosis.

Pulmonary Spindle Cell Carcinoma: As Rare as a Hen’s Teeth

“…The prognosis of SpCC is very poor. Only three out of 11 patients had a survival of more than two years in the case series of 11 patients by Qi et al [ 4 ].…”

Surgical resection of a rapidly growing pulmonary spindle cell carcinoma by robot-assisted thoracoscopic surgery: a case report

“…According to the 2015 WHO histological classification of lung tumors, pulmonary sarcomatoid carcinoma includes pleomorphic carcinoma, PSCC, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma [1]. Sarcomatoid carcinomas are mostly polymorphic carcinomas, accounting for 0.3 to 1.3% of all lung tumors, especially PSCC [1][2][3][4][5][6][7].…”

“…After the widespread use of the 2015 WHO histological classification of lung tumors, reports on PSCC have increased. Many reports confirm that cytology alone or endoscopic/percutaneous biopsy is very difficult to prove, as only spindle-shaped tumor cells need to be confirmed for diagnosis, and a definitive diagnosis is rarely obtained before surgery [1][2][3][4][5][6][7].…”

Dual COX‐2 and 15‐LOX inhibition study of novel 4‐arylidine‐2‐mercapto‐1‐phenyl‐1H‐imidazolidin‐5(4H)‐ones: Design, synthesis, docking, and anti‐inflammatory activity

“…It was reported that the expression of COX-2, [39] as well as the production of ROS and other inflammatory mediators, are induced in RAW 264.7 cells exposed to the bacterial toxin LPS. [40] Moreover, several compounds with antioxidant potential have also been found to be effective against inflammatory diseases and cancer, [40] highlighting oxidative stress as a possible target for developing new antiinflammatory candidates. We examined the ability of 2-oxo-imidazole derivatives 4a-r to reduce ROS production in macrophages activated by LPS.…”