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Sarcomatoid carcinoma of the lung
Author(s) -
Nakajima Masayoshi,
Kasai Takahiko,
Hashimoto Hiroshi,
Iwata Yasushi,
Manabe Hideo
Publication year - 1999
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19990815)86:4<608::aid-cncr9>3.0.co;2-1
Subject(s) - sarcomatoid carcinoma , pathology , medicine , carcinoma , adenocarcinoma , large cell , spindle cell carcinoma , lung , immunohistochemistry , lung cancer , population , cancer , environmental health
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.