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Pulmonary Pathology Online

Pathology of Pulmonary Carcinosarcoma

Dr Sampurna Roy MD            

 

                                                                                                                      

 

Carcinosarcomas are tumours that contain both carcinomatous and sarcomatous elements.

Visit: Biphasic Epithelial/ Mesenchymal Lung Tumours ; Pulmonary Blastoma

Pulmonary carcinosarcomas occur in the same age group as the more common forms of lung cancer and show a similar association with smoking.

Some form large intrapulmonary masses by the time they are detected but most arise in the walls of large airways and form polypoid endobronchial lesions, which cause obstructive pneumonitis at a relatively early stage, when successful treatment is still feasible.

However, in general the median survival of patients with either parenchymal or endobronchial carcinomas is similar to that of other forms of lung cancer, less than 10% of patients surviving two years.

Metastases may consist of carcinoma, sarcoma or both elements.

The most frequent microscopic combination is that of squamous cell carcinoma and spindle cell sarcoma - islands of neoplastic squamous epithelium are surrounded by a malignant mesenchyme of spindle and pleomorphic giant cells.

More rarely, the epithelial component has the feature of adenocarcinoma, large cell undifferentiated carcinoma or small cell carcinoma.

Glandular differentiation is commoner in peripheral growths.

Differentiation in the sarcomatous component may give rise to malignant osteoid, cartilage or even muscle, and osteoclast-like giant cells are occasionally conspicuous.

Such heterologous differentiation is now regarded as essential for the diagnosis of carcinosarcoma, otherwise similar mixed tumours are being termed sarcomatoid, spindle cell, giant cell or pleomorphic carcinoma depending upon the nature of their constituent parts.

Such tumours reflect the capacity of carcinomas for mesenchymal metaplasia so that there is a morphological continuum.

The term sarcomatoid carcinoma has much to commend it: monophasic sarcomatoid carcinoma is a synonym for spindle cell carcinoma and biphasic sarcomatoid carcinoma for carcinosarcoma showing heterologous differentiation.

Further reading:

Carcinosarcomas of the lung: a clinicopathologic study of 66 patients.

Pulmonary carcinosarcoma: report of a case with review of the literature.

Case of pulmonary carcinosarcoma and a summary of 17 cases reported in Japan.

True pulmonary carcinosarcoma suspected as a metastatic lung tumor.

A case of true pulmonary carcinosarcoma.

Pulmonary carcinosarcoma: radiologic and pathologic findings in three patients.

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

 


 

 

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