Cytopathologic features of pleomorphic carcinoma of the lung: case report

Pleomorphic carcinoma of the lung is a subtype of sarcomatoid carcinoma andessentially classified as a poorly-differentiated, non-small cell lungcarcinoma. Being a very rare tumor, it constitutes 0.3-1.3% of all malignanciesof the lung. Cytology reveals malignant fusiform and/or giant cells, accompaniedby malignant epithelial elements like squamous cell, adeno or large cellcarcinoma. Our case, a 76-year-old female patient, presented with chest and backpain. Thoracic CT showed a well-demarcated solid mass of 5x3 cm locatedperipherally in the left upper lobe of the lung. Trans-thoracic fine needleaspiration cytology showed atypical cells with a biphasic character in a myxoidmatrix. It was noted that of these, some were poorly-demarcated fusiform cellswith oval nuclei and marked nucleoli, while others were epithelial cells witheccentrically placed nuclei, large cytoplasms and macronucleoli. The patient wasdiagnosed as pleomorphic carcinoma on the basis of these findings, and thecytological diagnosis was confirmed by histopathology. Pleomorphic carcinoma isa poorly-differentiated non-small cell lung carcinoma, which poses diagnosticdifficulties. As it is rare, it lacks decisive diagnostic criteria and hascytological characteristics resembling those of other lung tumors.