Pleomorphic Carcinoma of the Lung

Abstract

Objective: To analyze the clinical and pathologic features of biopsy-proven pleomorphic carcinoma of the lung. Method: We retrospectively reviewed the data of patients with pleomorphic carcinoma of the lung, at a hospital in southern Taiwan. The computerized medical records database of Kaohsiung Veterans General Hospital (VGH-KS) was searched for patients who had pathological findings of pleomorphic carcinoma of the lung from 1999 through 2003. All of the medical records were reviewed, and a microscopic examination of the pathological specimens was performed once again. Results: Of the 10 patients with histologically confirmed pleomorphic carcinoma, 7 were men and 3 were women, and the median age was 69 years. Initial presenting symptoms were cough (n=10), fatigue (n=8), hemoptysis (n=5), chest wall pain (n=4), weight loss (n=4), dyspnea (n=4) and fever (n=1). The mean size of the tumors was 7.5 cm. The pathological specimens were obtained by transthoracic sono-guided biopsy, CT-guided biopsy or lobectomy during operation. Microscopically, the tumors of five patients were composed of spindle and giant cells exclusively, and the others had epithelial components with squamous cell carcinoma (n=3), adenocarcinoma (n=2) and large cell carcinoma (n=1). Six patients had immunohistochemical staining for their specimens. All of these specimens showed a positive result for cytokeratinstain. The average survival was 6 months. Conclusions: In our limited experience, the management of pleomorphic carcinoma is not different from that of other non-small cell lung carcinomas (NSCLC). But the histological findings are quite different. Sometimes pleomorphic carcinoma is regarded as sarcoma if there are no carcinomatous transition areas. The most common histological type among our cases was a tumor composed exclusively of spindle and giant cells.