pleomorphic carcinoma of lung

Resected case

of stage IV pleomorphic carcinoma of the lung with long-term survival. CT scan showed abnormal masses. a Chest CT scan showed a 42-mm tumor in the left lung S1 + 2 progressing to S6. b Abdominal enhanced CT scan showed a 82-mm mass with no active bleeding

surgicalcasereports.springeropen.com • CC-by-4.0

Resected case

of stage IV pleomorphic carcinoma of the lung with long-term survival. Imaging of FDG-PET. a There was high accumulation of FDG at the left lung tumor (SUVmax, 17.0). b There was slightly accumulation of FDG at the edge of abdominal tumor (SUVmax, 4.1)

surgicalcasereports.springeropen.com • CC-by-4.0

Radiopaedia • CC-by-nc-sa 3.0 • de

Pleomorphic carcinomas of the lung are a rare type of non-small cell lung carcinomas (NSCLC) classified under sarcomatoid carcinomas of the lungs.

Epidemiology

These tumors are thought to account for 0.1-0.4% of all lung malignancies.

Associations

There is a recognized association with smoking.

Pathology

Histologically, a pleomorphic carcinoma is defined as either:

a non–small cell lung carcinoma combined with neoplastic spindle and/or giant cells
or
a carcinoma that consists of only spindle and giant cells: due to this some publications may synonymously use the term with spindle cell carcinoma of the lung or giant cell carcinoma of the lung

At least 10% of the carcinoma should comprise spindle and/or giant cells for it to be classified as a pleomorphic carcinoma.

Radiographic features

There no published specific imaging features for this histological subtype. Most CT features are thought to be dependent on the epithelial component of the tumor .

The tumors can be either endobronchial (central) or peripheral (the latter location is considered commoner ). They can frequently involve the pleural and/or chest wall. Larger tumors may show central low attenuation. Some publications suggest an upper lobe predilection . While many can be well-defined, some can be lobulated, ill-defined or even spiculated .

Treatment and prognosis

A spindle cell histology is generally associated with a more aggressive clinical course . The presence of pleural invasion is associated with a much worse prognosis .