Carcinosarcomas of the lung: a clinicopathologic study of 66 patients.
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Cites background from "Carcinosarcomas of the lung: a clin..."
...PSC presents as either a central or peripheral lesion, often in the upper lobes.(8,9,13,19,26,27,29,30) It grows by invading the bronchial tree, the pulmonary parenchyma, and the adjacent anatomical structures (mediastinum and chest wall) in the form of widely necrotic and hemorrhagic, round to bosselated large masses, soft to variably firm,(3,5,8-10,13,25,27,38,46,60) sometimes rubbery to hard....
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...currently discouraged,(3) it is nonetheless worth mentioning, because it has been at the basis of the unifying concept of a pathologic continuum having overt “pure” carcinomas and “pure” pulmonary sarcomas at their extremes and including intermediate forms of carcinomas with variable amounts of sarcomatous and/or sarcomatoid elements (the so-called carcinomas “in transition”).(9,25) A substantial improvement in this still confusing nomenclature was provided by the 1999 WHO classification on lung cancers, with the statement that there existed “a group of poorly differentiated NSCLC containing a component of sarcoma or sarcoma-like elements” encompassing 5 different histological subtypes organized into 3 separate diagnostic categories: carcinomas with spindle and/or giant cells (pleomorphic carcinoma, spindle cell carcinoma, and giant cell carcinoma), carcinosarcomas, and pulmonary blastomas....
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...Although combinations with angiosarcoma or malignant peripheral nerve sheath tumor are theoretically possible in pulmonary carcinosarcomas, they have not been recorded in any of the major published series of these tumors.(9) Rather, sarcomatoid carcinomas resembling angiosarcomas because of the presence of freely anastomosing channels containing erythrocytes or forming blood lakes covered by anaplastic, plump epithelioid cells, or dissecting alveolar septa in a hemorrhagic background are best viewed as pseudoangiosarcomatous carcinomas, because they lack true endothelial differentiation....
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Cites background from "Carcinosarcomas of the lung: a clin..."
...Metastases can contain both histologic components of the primary tumor; carcinoma is the most common type encountered if only 1 component is found.(4,24)...
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...Squamous cell carcinoma is the most common histologic type of carcinoma (Figure 9, A), followed by adenocarcinoma (Figure 9, B) and adenosquamous carcinoma.(4,24) The sarcomatous component can consist of various patterns including pure components or mixtures of rhabdomyosarcoma, chondrosarcoma, or osteosarcoma....
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...S100 will stain the chondrosarcoma component.(7,24) Dacic et al(16) analyzed loss of heterozygosity with 12 polymorphic microsatellite markers and found extensive allelic loss in both the epithelial and mesenchymal components, especially for 3p, 5q, and 17p....
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...Keratin may be helpful in confirming the carcinoma component.(7,24) Adenocarcinoma components may be positive for TTF-1, and squamous cell carcinoma components may express p63....
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...A central location, sometimes with endobronchial involvement, can be seen in all sarcomatoid carcinomas, but it is seen more often in carcinosarcomas and least often in pleomorphic carcinomas.(4,8,26,19,21,24) They are circumscribed and unencapsulated, with a variegated, white, tan, or gray, or hemorrhagic cut surface....
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References
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