Pleomorphic Carcinoma Of Lung Research Articles

Pleomorphic Carcinoma of Pulmonary Location: Case Report and Review of the Literature

Pulmonary pleomorphic carcinoma is a rare primary lung tumor, part of the group of non-small cell cancers. We report the case of a 54-year-old patient, a chronic smoker who presented with hemoptysis evolving in a context of deterioration in general condition. Chest imaging revealeda left upper lobar tissue density mass with some hypodensity. The diagnosis of pleomorphic lung carcinoma was made based on histological data from bronchial biopsies, and classified as stage IVb according to the TNM classification (8th edition). Palliative chemotherapy was then offered to the patient. The evolution was marked by the death of the patient 2 months after diagnosis. Through this observation, we wish to shed light on this rare and particular histological type but just as aggressive as other pulmonary neoplasias.

Pleomorphic carcinoma of the lung revealed by uncommon colonic metastasis: An exceptional case report with literature review.

Lung pleomorphic carcinoma is a rare and aggressive cancer that uncommonly metastasizes to the colon and only a few case reports have been published thus far. We present an exceptional case of colon metastasis from lung pleomorphic carcinoma in a 68-year-old man which was revealed by large bowel perforation, and we review the previous three published cases. Metastasis to the bowel from primary lung malignancy often lacks specific symptoms which result in delayed diagnosis. Bowel metastasis is a poor prognostic factor in patients with lung pleomorphic carcinoma, regardless of management strategy.

P1.21-21 PD-L1 Expression in Surgically Resected Lung Pleomorphic Carcinoma - One-centre Study of 107 Patients

P1.21-21 PD-L1 Expression in Surgically Resected Lung Pleomorphic Carcinoma - One-centre Study of 107 Patients

183 - Pleomorphic lung carcinoma – a rare response to a rare tumour

183 - Pleomorphic lung carcinoma – a rare response to a rare tumour

A Case of a Long-term Survival Following Multi-modality Therapy for Lung Pleomorphic Carcinoma with Right Aortic Arch

A Case of a Long-term Survival Following Multi-modality Therapy for Lung Pleomorphic Carcinoma with Right Aortic Arch

133 - PD-L1 expression in pleomorphic lung carcinoma with STK11 mutations

133 - PD-L1 expression in pleomorphic lung carcinoma with STK11 mutations

P1.04-63 Correlation of Mutations in TP53, CDKN2A and PIK3CA with VISTA Expression in Pleomorphic Lung Carcinoma

P1.04-63 Correlation of Mutations in TP53, CDKN2A and PIK3CA with VISTA Expression in Pleomorphic Lung Carcinoma

1O - Impact of MET variants on PD-L1 expression in pleomorphic lung carcinoma

1O - Impact of MET variants on PD-L1 expression in pleomorphic lung carcinoma

A right upper lobectomy with two malignancies and three distinct pathologies – a case report

Lobectomy resections for malignant tumours is a common procedure that allows for potential curative resection, histological diagnosis and eventual discussions of adjuvant treatment options. This case discusses a 75-year-old male who presented for right upper lobectomy for a suspicious lesion within the lung on PET-CT. FNA showed large cell malignant features whilst core biopsy was inconclusive. On macroscopic dissection of the specimen it was noted that two distinct and morphologically different lesions existed within the parenchyma. Microscopic assessment of the suspicious lesion showed a pleomorphic lung carcinoma and the second lesion a cryptococcoma. In addition, the background lung tissue showed a lymphocytic infiltrate that was ultimately confirmed as chronic lymphocytic leukaemia/lymphoma. The patient was commenced on fluconazole treatment, has bone marrow progressive CLL and remains reoccurrence free for the pleomorphic lung carcinoma. This case highlights the rare instances where meticulous investigation of specimens can yield additional pathologies that can alter treatment in patients with active infection and immunosuppression.

Intratumoral heterogeneity in PD-L1 expression in pleomorphic lung carcinoma: implications for management of stage III disease

Intratumoral heterogeneity in PD-L1 expression in pleomorphic lung carcinoma: implications for management of stage III disease

MA21.03 Heterogeneity in MET Copy Number and Intratumoural Subsets in Pleomorphic Lung Carcinoma: Implications for MET Directed Therapy in NSCLC

MA21.03 Heterogeneity in MET Copy Number and Intratumoural Subsets in Pleomorphic Lung Carcinoma: Implications for MET Directed Therapy in NSCLC

Pleomorphic Spindle and Giant Cell Carcinoma of Lung With Widespread Metastases: An Autopsy Case Report

Pleomorphic Spindle and Giant Cell Carcinoma of Lung With Widespread Metastases: An Autopsy Case Report

術前化学療法中に腫瘍穿破をきたした肺多形癌の1例

症例は63歳男性．主訴は咳嗽．胸部CTで左下葉に径72 mmの腫瘤影を認めた．精査の結果，低分化非小細胞肺癌，cT3（PM1）N2M0 StageIIIAと診断した．導入化学療法の適応と考え，cisplatin（以下CDDP）＋tegafur-gimeracil-oteracil potassium（以下TS-1）による全身化学療法を開始したところ，day7の胸部X線でniveauを形成する多房性胸水を認めた．腫瘍の胸膜穿破に伴う有瘻性膿胸と診断し，緊急手術を施行した．病理組織学的な最終診断は肺多形癌の診断であり，腫瘍の壊死は臓側胸膜に及んでいた．術後CDDP＋TS-1を3コース施行し，現在2年経過，無再発生存中である．腫瘍内部に空洞形成など壊死傾向の強い腫瘍に対する術前化学療法では腫瘍の自壊，破裂の危険性があり，緊急手術が必要となることもある．

肺原発多形癌の切除例13例の検討

目的．肺原発多形癌は1999年に初めて提唱された組織型である．全肺癌の1.6～2.6%と比較的稀な腫瘍であり，複数の手術例をまとめた報告は少ない．方法．2007年2月から2013年2月までの間に当科において手術を施行した肺原発多形癌13例を対象とした．患者背景，治療内容，予後等について検討した．結果．年齢は41～84歳（中央値67歳），男性9例，女性4例．術式は二葉切除1例を含む肺葉切除11例，部分切除2例であった．7例で再発し，うち5例は死亡した．無再発生存期間は38～2801日（中央値562日）であった．初診時に脳転移のためIV期と診断された症例では，ガンマナイフと肺切除施行後に鎖骨上窩リンパ節転移をきたし，放射線化学療法を施行した．腫瘍縮小効果はCRで，その後の再発は認めず，再発後1816日の生存が得られている．結論．肺原発多形癌は予後が不良であり化学療法の効果は不明であるが，多形癌の中にも比較的良好な予後を示す症例が存在する可能性がある．

English

English

Pleomorphic Carcinoma of the Lung: Relationship Between CT Findings and Prognosis.

The objective of our study was to assess the radiologic and clinical findings of pleomorphic carcinoma (PC) of the lung and to evaluate whether there are any characteristic features that can be used to predict prognosis. Forty-four consecutive patients whose diagnosis of PC was histologically confirmed through resection of the lung tumor were included in this study. The clinical and CT findings of these patients were retrospectively reviewed. Two thoracic radiologists evaluated the CT findings including the size, location, internal characteristics, and margin characteristics of the tumors and the presence of chest wall invasion, mediastinal invasion, and surrounding lung abnormalities. A multivariate analysis by the Cox proportional hazards regression model was used to identify variables that can be used to predict overall survival and disease-free survival. In the patients with PC, a central low-attenuation area or cavity (40/44, 91%), chest wall invasion (19/44, 43%), and pulmonary emphysema (30/44, 68%) were frequently observed on CT. On multivariate analysis, a massive central low-attenuation area or cavity (> 25% of the lesion) on CT indicating necrosis was the only significant independent factor for overall survival and disease-free survival (p < 0.05). Clinical findings, the presence of lymph node metastasis at surgery, and postoperative pathologic stage were not significant predictors of overall survival and disease-free survival. A massive central low-attenuation area or cavity on CT was the only predictor of overall survival and disease-free survival in patients with lung PC.

Coronary Embolization Caused by Pleomorphic Lung Carcinoma

A 73-year-old man who had been transferred to our emergency room due to sudden chest pain was diagnosed with ST-segment elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention was performed. A long, white object which looked like a parasitic worm was retrieved via intracoronary aspiration and revascularization was successfully completed. Contrast computed tomography revealed a huge 7×6 cm mass in the right upper pulmonary lobe with direct pulmonary vein invasion. Histopathologic examination of the aspirated coronary object revealed pleomorphic lung carcinoma. This is an unusual case of STEMI caused by lung tumor embolization via direct pulmonary vein invasion to the left side of the heart.

肺腺扁平上皮癌，肺多形癌のCT画像と臨床像

肺腺扁平上皮癌，肺多形癌のCT画像と臨床像

肺原発多形癌切除例の検討

肺原発多型癌（pleomorphic carcinoma）は1999年のWHO分類第3版で提唱された稀な組織型で，肉腫成分の紡錘細胞や巨細胞を少なくとも10％以上含む非小細胞肺癌で予後不良とされている．今回われわれは，2007年10月から2014年3月までの期間で，当院で肺癌に対して手術を施行した389例中，肺原発多型癌と診断された15例の検討を行った．性別は男性12例・女性3例で，年齢の中央値は65歳（54～83歳）であった．再発は10例に認め，そのうち6例は原病死した．再発を認めた10例の再発までの中央値は107日（17～301日）で9例は術後6カ月以内の再発であった．2年以上の無再発生存症例は2例に認め，1例は局所進行症例だったが，両者ともリンパ節転移陰性だった．肺原発多型癌は予後不良な腫瘍だが，局所進行の症例でもリンパ節転移が陰性であれば予後が期待出来る症例が存在する．

肺癌と原発不明縦隔リンパ節癌の同時二重癌の術後10年目に発生した異時多発肺多形癌

症例は60歳男性．レントゲンで右上肺野異常影を指摘され，CT検査で右S1に25 mm大の結節を認めたが明らかなリンパ節腫大は認めなかった．右肺癌の診断で右上葉切除術＋ND2aリンパ節郭清を行った．病理検査では上葉の腫瘍は高分化型腺癌であったが，気管気管支リンパ節に大細胞癌を認めた．肺高分化型腺癌pT1N0M0, Stage IAと原発不明縦隔リンパ節大細胞癌の同時性二重癌と考えフォローアップした．無再発で10年経過し左上葉に肺癌を疑う腫瘤が出現し，左上葉切除を行うと組織学的には紡錘形癌と腺癌よりなる多形癌であった．右上葉腺癌と左上葉多形癌は，縦隔リンパ節大細胞癌とは組織学的に異なる癌と診断された．原発不明縦隔リンパ節癌は稀で，肺癌手術で偶然発見された場合には，切除肺に原発巣が隠れている可能性があるが，慎重な病理学的検索にも関わらず原発巣が見つからない場合には，厳重なフォローアップが必要である．