Carcinosarcoma of the lung with spindle-cell epithelial component: Report of a case
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Abstract A case of primary endobronchial carcinosarcoma with predominant spindle cell squamous carcinoma is described. The spindle cell component has not been previously reported as occurring in pulmonary carcinosarcomas. We suggest that this variety of carcinosarcoma closely resembles sarcoma of the lung histologically and emphasize that a distinction between the two neoplasms is important in view of the generally good prognosis of endobronchial carcinosarcomas.Keywords:
Carcinosarcoma
Component (thermodynamics)
Spindle cell carcinoma
Sarcomatoid carcinomas and carcinosarcomas are histologically malignant biphasic neoplasms with an epithelial and a spindle cell component. Both a polyclonal and a monoclonal origin have been postulated for these tumours, but the latter has been favoured. For carcinosarcoma, the stem cell from which the epithelial and mesenchymal components are derived is expected to be more immature than the epithelial stem cell from which different components of sarcomatoid carcinoma originate, since in the latter, immunohistochemical or ultrastructural epithelial characteristics are still detectable. In the present study, comparative genomic hybridization was used to test the hypothesis that both tumour components in sarcomatoid carcinoma have more chromosomal aberrations in common than those in carcinosarcoma. From three sarcomatoid carcinomas originating from the urinary bladder and two carcinosarcomas from the pharynx, the epithelial and spindle cell components were microdissected and analysed for their respective chromosomal aberrations, using comparative genomic hybridization. High-level homology was seen in chromosomal aberrations between the different components in each tumour. This level of homology was even higher in the carcinosarcomas (65 and 91 per cent) than in both sarcomatoid carcinomas (21-51 per cent). The different phenotypic components of both sarcomatoid carcinoma and carcinosarcoma show a large overlap of chromosomal aberrations, strongly suggesting a monoclonal origin for all of these tumours. These findings do not support the hypothesis that the divergence between epithelial and spindle cell components occurs at an earlier stage in carcinosarcomas than in sarcomatoid carcinoma.
Carcinosarcoma
Sarcomatoid Carcinoma
Spindle cell carcinoma
Comparative genomic hybridization
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Sarcomatoid carcinomas and carcinosarcomas are histologically malignant biphasic neoplasms with an epithelial and a spindle cell component. Both a polyclonal and a monoclonal origin have been postulated for these tumours, but the latter has been favoured. For carcinosarcoma, the stem cell from which the epithelial and mesenchymal components are derived is expected to be more immature than the epithelial stem cell from which different components of sarcomatoid carcinoma originate, since in the latter, immunohistochemical or ultrastructural epithelial characteristics are still detectable. In the present study, comparative genomic hybridization was used to test the hypothesis that both tumour components in sarcomatoid carcinoma have more chromosomal aberrations in common than those in carcinosarcoma. From three sarcomatoid carcinomas originating from the urinary bladder and two carcinosarcomas from the pharynx, the epithelial and spindle cell components were microdissected and analysed for their respective chromosomal aberrations, using comparative genomic hybridization. High-level homology was seen in chromosomal aberrations between the different components in each tumour. This level of homology was even higher in the carcinosarcomas (65 and 91 per cent) than in both sarcomatoid carcinomas (21–51 per cent). The different phenotypic components of both sarcomatoid carcinoma and carcinosarcoma show a large overlap of chromosomal aberrations, strongly suggesting a monoclonal origin for all of these tumours. These findings do not support the hypothesis that the divergence between epithelial and spindle cell components occurs at an earlier stage in carcinosarcomas than in sarcomatoid carcinoma. Copyright © 1999 John Wiley & Sons, Ltd.
Carcinosarcoma
Sarcomatoid Carcinoma
Spindle cell carcinoma
Comparative genomic hybridization
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Carcinosarcoma
Sarcomatoid Carcinoma
Spindle cell carcinoma
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Carcinosarcoma
Histogenesis
Spindle cell carcinoma
Spindle cell sarcoma
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Pulmonary sarcomatoid carcinomas (PSC) are an uncommon form of non-small cell lung cancer and are found in 0.4% of all lung malignancies. The five histologic variants include: Pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma and pulmonary blastoma.
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Sarcomatoid Carcinoma
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Abstract A case of primary endobronchial carcinosarcoma with predominant spindle cell squamous carcinoma is described. The spindle cell component has not been previously reported as occurring in pulmonary carcinosarcomas. We suggest that this variety of carcinosarcoma closely resembles sarcoma of the lung histologically and emphasize that a distinction between the two neoplasms is important in view of the generally good prognosis of endobronchial carcinosarcomas.
Carcinosarcoma
Component (thermodynamics)
Spindle cell carcinoma
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Carcinosarcomas are rare tumors, which are usually composed of carcinomatous areas close to or intermixed with sarcomatous components. Only 6 cases of carcinosarcoma of the colon have been reported in the English literature previously. We describe the 7th case, an 82-year-old man with a skin metastasis from the spindle cell component of a rectal carcinosarcoma. On rectal exploration, a large, firm tumor was palpated 2 cm from the anal verge. Endoscopic examination revealed a tumor projecting into the lumen, and hemorrhage from the tumor surface. We performed a low anterior resection. The resected specimen contained an ulcerative lesion with a round wall in continuity with a papillary tumor. Carcinoma and sarcoma components existed concomitantly along with transitional features. Immunohistochemistry disclosed immunoreactivity for vimentin in most of the spindle cell areas. Carcinoembryonic antigen was positive in the adenocarcinomatous component. One month after surgery, the patient developed a skin metastasis on the back. The skin biopsy specimen contained proliferating spindle cells almost identical to those of the primary lesion. The patient died of carcinosarcoma 6 months after surgery. In this paper, we review 7 cases of colorectal carcinosarcoma, including our patient, who is only the 7th such reported case.
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Spindle cell carcinoma
Spindle cell sarcoma
Carcinoembryonic antigen
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Carcinosarcoma is a rare, malignant tumor of the breast, consisting of intraductal or infiltrating carcinoma contiguous or subtly merged with a highly cellular, mitotically active pleomorphic spindle cell stroma (sarcoma). It is a form of the metaplastic mammary carcinomas and it is probably derived of myoepithelial cells. We report two cases of breast carcinosarcoma in two white women. The patients, following a frozen section positive for malignancy, had had a modified radical mastectomy. Paraffin sections and positive immunohistochemical cell staining (in our first case) confirmed the diagnosis of carcinosarcoma. This tumor should be distinguished from other forms of metaplastic carcinomas because it is very aggressive and has an ominous prognosis.
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Metaplastic Carcinoma
Spindle cell carcinoma
Spindle cell sarcoma
Modified Radical Mastectomy
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Abstract We have examined 18 primary malignant lung tumours categorized as either carcinosarcoma, blastema or spindle‐cell carcinoma according to accepted criteria. Two monoclonal antibodies to keratins, CAM 5.2 and LP 34, were used to determine whether the non‐epithelial or spindle‐cell components of each tumour showed evidence of keratin expression. By this means the epithelial nature of the five tumours classified as spindle‐cell carcinomas was confirmed. In all four pulmonary blastomas and in five of nine carcinosarcomas, the sarcomatous elements failed to stain for keratin but in the remaining four carcinosarcomas there was focal staining. The histogenesis of these tumours is discussed and it is suggested that the sarcomatous component of a carcinosarcoma may be derived from malignant epithelial cells by a process of mesenchymal metaplasia with a switch in intermediate filament type. It remains uncertain whether blastomas are derived from both endoderm and mesoderm, or from either one of these tissues, with one component representing complete metaplastic transformation.
Carcinosarcoma
Histogenesis
Spindle cell carcinoma
Sarcomatoid Carcinoma
Metaplasia
Pulmonary Blastoma
Metaplastic Carcinoma
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Carcinosarcoma
Spindle cell carcinoma
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