Primary Pulmonary Sarcomatoid Carcinoma Research Articles

"Rare Primary Pulmonary Sarcomatoid Carcinoma with Isolated Pancreas Metastasis: Case Report and Literature Review"

"Rare Primary Pulmonary Sarcomatoid Carcinoma with Isolated Pancreas Metastasis: Case Report and Literature Review"

Preoperative systemic immune-inflammation index predicts survival and recurrence in patients with resected primary pulmonary sarcomatoid carcinoma.

BackgroundPulmonary sarcomatoid carcinoma (PSC) is a rare lung cancer subtype. Studies concerning PSC are limited and controversial; therefore, we analyzed the treatment and outcomes of PSC utilizing a relatively large single-institution database.MethodsFrom January 2003 to December 2018, 262 consecutive PSC patients treated at our institution were retrospectively reviewed. The clinical characteristics, treatments, and outcomes were analyzed.ResultsThe median survival time (MST) was 22.0 months, with 1-, 3-, and 5-year overall survival (OS) rates of 59.9%, 40.1%, and 36.1%, respectively. Patients who underwent surgery had a significantly better prognosis than patients who received nonsurgical treatment (MST, 23.0 vs. 11.0 months, P=0.016). The use of surgery followed by adjuvant therapy significantly prolonged survival in stage III patients (MST, 17.0 vs. 8.0 months, P=0.003) but not in stage I and II patients. Multivariate analysis showed that a systemic inflammation-immune index (SII) value >430.8, TNM stage and necrosis were independent prognostic predictors of OS and disease-free survival (DFS) in radically resected PSC patients (P<0.05). In addition, SII and necrosis were independent risk factors for recurrence after the radical resection of PSC (P<0.05).ConclusionsPSC is aggressive and has a poor prognosis. Surgery should be the mainstay treatment for operable cases, and adjuvant therapy is recommended for locally advanced disease. A novel potential biomarker, SII, which is an integrated parameter based on preoperative lymphocyte, neutrophil, and platelet counts, may be useful for prognostic prediction and the identification of resected PSC patients at high risk for recurrence.

Sarcomatoid Carcinoma of the Lung: A Rare and Unfortunate Disease

Pulmonary sarcomatoid carcinoma (PSC) is an extremely rare malignancy with a poor overall survival rate. Sarcomatoid tumors (SC) can arise out of many organs in the body and are generally rare but primary PSC’s are among the rarest. Of all lung tumors, PSC’s represent less than 1%. Our case presents a male with a past medical history of chronic obstructive pulmonary disease (COPD) who presents with a pleural effusion secondary to PSC.

Perioperative change in neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor in patients with completely resected primary pulmonary sarcomatoid carcinoma.

There has been controversy regarding prognostic factors for surgically resected primary pulmonary sarcomatoid carcinoma (PSC). Recently, several studies have shown that neutrophil-to-lymphocyte ratio (NLR) was a prognostic factor for various types of cancers from multiple organs. Therefore, we performed this study to evaluate whether NLR is related to prognosis after complete surgical resection of primary PSC. From Oct. 2003 to Sep. 2015, a total of 50 patients underwent surgical resection for primary PSC. After excluding patients with any history of other malignancy and incompletely resected cases, a total of 37 patients were included, and data were retrospectively collected and analyzed. Change in postoperative NLR and the initial NLR (ΔNLR) was calculated from the perioperative complete blood count (CBC) results. Mean age of the cohort was 62.2±1.9 years, and 31 patients (83.8%) were male. Twenty patients (54.1%) were revealed as pN0. Overall 5-year survival rate was 50.3%. Seventeen patients (45.9%) had locoregional or distant metastases. Univariate survival analysis revealed age >70, ΔNLR >17 as risk factors for overall survival (P=0.009, 0.005) and disease-free survival (P=0.036, 0.018). Multivariate Cox-regression analysis revealed age >70 and ΔNLR >17 as independent risk factors for overall survival and ΔNLR >17 as the only independent risk factor for the disease-free survival. In patients with completely resected primary PSC, perioperative ΔNLR had a significant effect on the overall survival and disease-free survival. Older age was also an independent risk factor for overall survival.

Computed Tomographic and Pathological Features of Primary Pulmonary Sarcomatoid Carcinoma.

To investigate the computed tomographic (CT) and pathological features of primary pulmonary sarcomatoid carcinoma (PSC). The clinical data and CT images of 20 patients with pathologically confirmed PSC were retrospectively analyzed. Solitary pulmonary mass was identified in 18 patients and multiple pulmonary masses in 2 patients, amounting to 22 masses. There were 17 peripheral masses and 5 central masses, including 11 masses larger than 5 cm. The smooth margin was identified in 9 masses, deep lobulation and/or spinous protuberance in 11 masses, and ill-defined margin in 2 masses. Pleural indentation was identified in 2 masses and pleural thickening with wide basement was identified in 14 masses. On plain CT, cavity was observed in 5 masses, hypo-density in 7 masses, and homogeneous density in 10 masses. On contrast-enhanced CT scanning, irregular ring/patchy enhancement were shown in 15 masses and slightly homogenous enhancement in 2 masses. Of all patients, 6 patients had unilateral or bilateral hilar and/or mediastinal lymphadenopathy. There were 16 pleomorphic carcinomas and 4 spindle cell carcinomas. Immunohistochemically, anti-pan cytokeratin antibody was positive in 13 patients, cytokeratin was positive in 8 patients, Vimentin was positive in 15 patients, epithelial membrane antigen was positive in 1 patient, and thyroid transcription factor-1 was positive in 8 patients. PSC has some specific CT features; however, the final confirmation of PSC still depends on pathological and immunohistochemical examinations.

Multi-slice computed tomography manifestation of primary pulmonary sarcomatoid carcinoma

Retrospective analysis of multi-slice computed tomography (MSCT) manifestations were conducted for 8 cases of pathologically confirmed primary pulmonary sarcomatoid carcinoma. And the relevant literature was also reviewed. The lesion sites were right upper lobe (n=5), lower lobe (n=2) and left upper lobe (n=1). One case was difficult to distinguish because of its huge mass and the remainder was all peripheral. With pseudocapsule (n=4), coarse calcification (n=1), hilar & mediastinal node metastasis (n=2) and cavity (n=1). The manifestations included extensive lung alveolar septal thickening & ground glass (n=1) and massive deep leaf & glitches (n=2). The scans were non-enhanced alone (n=1) and non-enhanced & enhanced (n=7). Six cases had shaped enhancement while another 5 uneven thickness of annular enhancement. And 4 cases had floating-ice change. Primary pulmonary sarcomatoid carcinoma is common in subpleural lung lobe. And the floating-ice sign is valuable in the diagnosis of sarcomatoid carcinoma. Key words: Lung; Primary sarcomatoid carcinoma

Findings on computerized tomography of primary pulmonary sarcomatoid carcinoma in 30 patients

Findings on computerized tomography of primary pulmonary sarcomatoid carcinoma in 30 patients

Pulmonary sarcomatous tumors.

Abstract Context.—Sarcomatous pulmonary neoplasms are a rare and diagnostically challenging group of tumors. Primary pulmonary sarcomas must be distinguished from the more frequent occurrence of sarcoma metastatic to the lung, primary pulmonary sarcomatoid carcinoma, and diffuse malignant mesothelioma involving the lung. In current practice, the general availability of ancillary diagnostic techniques, such as immunohistochemistry and molecular analysis, can reliably classify many sarcomatoid lesions. Objective.—To review the literature and report on additional primary material about the application of immunohistochemistry and molecular analysis in the differential diagnosis pulmonary sarcomatous neoplasms. Data Sources.—Literature review of relevant articles indexed in PubMed (National Library of Medicine) between 1961 and 2007 and primary material from the author's institution. Conclusions.—This review discusses specific criteria for the diagnosis of primary lung sarcomas and offers a practical approach ...

Pulmonary Sarcomatous Tumors

Sarcomatous pulmonary neoplasms are a rare and diagnostically challenging group of tumors. Primary pulmonary sarcomas must be distinguished from the more frequent occurrence of sarcoma metastatic to the lung, primary pulmonary sarcomatoid carcinoma, and diffuse malignant mesothelioma involving the lung. In current practice, the general availability of ancillary diagnostic techniques, such as immunohistochemistry and molecular analysis, can reliably classify many sarcomatoid lesions. To review the literature and report on additional primary material about the application of immunohistochemistry and molecular analysis in the differential diagnosis pulmonary sarcomatous neoplasms. Literature review of relevant articles indexed in PubMed (National Library of Medicine) between 1961 and 2007 and primary material from the author's institution. This review discusses specific criteria for the diagnosis of primary lung sarcomas and offers a practical approach to excluding other sarcoma-like lesions involving the lung. The pathologist has an essential role in evaluating these tumors and will often be the first to suggest an unusual, alternative diagnosis, which may have significant implications for patient care, therapy, and prognosis.

Primary pulmonary sarcomatoid carcinoma with intracardiac extension

Primary pulmonary sarcomatoid carcinoma is rare. It is generally regarded as an aggressive tumor. We report, to our best knowledge, the first case of pulmonary sarcomatoid carcinoma with extensive intracardiac spread. This case illustrated the misleading clinical features of this condition. Previous literature is also reviewed.