Sarcomatoid carcinoma of the lung

Abstract

BACKGROUND Spindle and giant cell carcinomas of the lung are rare subtypes and are regarded as one type of lung carcinoma, termed pleomorphic carcinoma in the Armed Forces Institute of Pathology classification. This classification is different from the World Health Organization classification. METHODS Thirty‐seven cases of sarcomatoid (spindle and/or giant cell) carcinoma of the lung were studied by light microscopy, conventional histochemistry, and immunohistochemistry to establish their clinical and histologic characteristics. RESULTS The patient population was comprised of 29 men and 8 women ages 33–81 years. Seventeen patients died of their disease and there was no statistically significant difference in patient prognosis between sarcomatoid carcinoma and nonsarcomatoid carcinoma of the lung. Using light microscopy, 5 cases (13.5%) comprised entirely of sarcomatoid components without carcinomatous elements were classified as Group A. In the remaining 32 cases (86.5%), classified as Group B, carcinomatous components were present (adenocarcinoma [18 cases; 48.7%], squamous cell carcinoma [8 cases; 21.6%], and large cell carcinoma [6 cases; 16.2%]). Sarcomatoid components were divided further into three categories: spindle cell type, giant cell type, and mixed spindle and giant cell type. Immunohistochemically, the sarcomatoid components of all 37 cases were positive for cytokeratins. Statistically, there was no significant prognostic difference between the 37 cases of sarcomatoid carcinoma and 647 cases of nonsarcomatoid, nonsmall cell carcinoma of the lung (P = 0.8537). CONCLUSIONS The sarcomatoid portions in all sarcomatoid carcinomas in the current study showed an epithelial differentiation, and there was no apparent difference in biologic behavior between sarcomatoid carcinoma and ordinary lung carcinoma. Cancer 1999;86:608–16. © 1999 American Cancer Society.

Clinical Significance and Next-Generation Sequencing of Chinese Pulmonary Sarcomatoid Carcinoma

“…Interestingly, we also identified 2 patients with combination mutations. One patient had EGFR and TP53 mutations, and the other had an EML4-ALK gene fusion and a TP53 mutation, which have rarely been described in PSC tumors 21 . Several studies have suggested that the reversion of functional TP53 can trigger tumor cell death and lead to tumor clearance, even if a tumor carries multiple genetic alterations that drive tumor growth 27, 28 .…”

“…Histology and immunohistochemistry are the gold standards for the diagnosis of PSC. Regarding immunohistochemistry, CEA, EMA, CK, CK7, chromogranin A, CD56, and synaptophysin can be used as markers for carcinomatous components, and desmin, vimentin, and smooth muscle/sarcomeric actin can be used as markers for sarcomatous elements 17, 21 .…”

Pulmonary sarcomatoid carcinoma: a clinicopathologic study and prognostic analysis of 51 cases

“…The prognosis remains controversial. Although some insist that the prognosis of PSC is less favorable than other NSCLC among postoperative patients [1,5,6], others see no difference between PSC and other NSCLC [7,8]. …”

Upper lip metastasis of sarcomatoid carcinoma of the lung – an unusual site of disease: a case report

“…The average age at diagnosis is 60 to 65 years [1, 3, 5–15]. Several studies suggested an increased male prevalence [1, 2, 4, 5, 8, 11], while others, including the largest epidemiologic study to date using the Surveillance, Epidemiology, and End Results database, suggested a nearly 1-to-1 gender ratio [3, 12]. Sarcomatoid carcinoma is associated with heavy tobacco smoking history [1, 9, 15].…”