Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma
Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma
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DOI：
10.1016/s0169-5002(01)00224-0
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发表时间：
2001-10-01
期刊：
影响因子：
5.3
通讯作者：
Wu, CT
中科院分区：
文献类型：
--
作者：
Cheng, YL;Lee, YC;Wu, CT
多形性（梭形）细胞癌，也称为多相肉瘤样癌，是一种罕见的原发性肺部恶性肿瘤。这种类型的肿瘤同时存在恶性上皮和同源肉瘤样梭形细胞成分，共表达不同程度的细胞角蛋白和波形蛋白。16例（4例中央型支气管内病变，12例周围型支气管实质肿块）进行了临床病理研究。男人比女人更容易受到影响（13：3）。患者年龄在56至80岁之间。这种疾病与吸烟密切相关。在7例接受手术切除的患者中，4例有纵隔、胸膜和胸壁侵犯，3例有区域淋巴结转移。所有患者均死于早期远处转移（范围2周至5个月），包括脑、骨、肾上腺和不常见部位，如食管、空肠、直肠和肾脏。不能手术的9例均为晚期疾病，经放化疗治疗无效。中位生存期为3个月。所有实质肿块均呈空洞状，中央坏死明显，仅残留肿瘤细胞边缘。更明确的诊断结果将取决于进一步的组织切片，并可通过免疫组化研究证实。Ki-67、p53和c-er B B-2癌蛋白表达也明显减少。(C)2001爱思唯尔科学爱尔兰有限公司保留所有权利。
Pleomorphic (spindle) cell carcinoma, also known as monophasic sarcomatoid carcinoma, is a rare primary pulmonary malignancy. This type of tumor shows concurrent presence of malignant epithelial and homologous sarcomatoid spindle cell components by coexpressing cytokeratin and vimentin in various degrees. Sixteen cases (four central endobronchial lesions and 12 peripheral parenchymal masses) were studied clinicopathologically. Men were affected far more frequently than women (13:3). The patients were between 56 and 80 years of age. The disease is strongly associated with smoking. Among seven of the patients who underwent surgical resection, four of them had mediastinum, pleura and chest wall invasions, and three of them had regional lymph node metastases. All of the patients succumbed to early distant metastases (range 2 weeks-5 months) in organs including brain, bone, adrenal gland, and unusual sites such as esophagus, jejunum, rectum and kidney. The remaining nine inoperable cases were late sta-e disease and treated with chemoradio therapy with little effect. The median duration of survival was 3 months. All parenchymal masses appeared as cavities with marked central necrosis, and only peripheral rim of tumor cells was left. More definite diagnostic results will depend on further tissue sections and can be confirmed by immunohistochemical studies. Significantly fewer Ki-67, p53 and c-erb B-2 oncoprotein expressions were also noted. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.