Cytodiagnosis and Tissue Culture of the Uterine Carcinosarcoma

Abstract

We attemped successively to use specific stains in smear specimens such as phosphotungustic acid-hematoxylin (PTAH), Van-Gieson (VG) and Heidenhain Mallory azan, and were able to diagnose a uterine carcinosarcoma (undifferentiated adenocarcinoma plus leiomyosarcoma). The myofibrils in cytoplasm were stained blue by PTAH, yellow by VG and red by azan. We also cultured this tumor and established 2 different types of clonal strains.The histogenesis of carcinosarcoma is obscure. Indeed, in the past, opinions have varied as follows, collision tumor, composition tumor, combination tumor and others. In vitro culture of carcinosarcoma, we could separated two distinct cell types. One cell type had characteristics of carcinoma, the other, of sarcoma. The two typed cells were also distinguished by chromosomal analysis. The results from cell culture support the combination tumor theory that carcinosarcomas development from multipotential stem cell and diffusely intermix carcinomatous and sarcomatous elements, rather than composition tumor theory that the exudation and inflammation accompaning of undifferentiated carcinomas of the endometrium favor the growth of atypical cells resulted in the histologic appearance of sarcoma. As far as we are aware, establishment of clonal strains from human carcinosarcoma has never been reported.