肺肉瘤样癌17例临床及病理分析

目的分析肺肉瘤样癌(PSC)的临床及病理特点。方法对17例经组织病理学确诊的PSC患者的临床表现、辅助检查、病理及免疫组化特点进行回顾性分析。结果PSC发病部位以右肺上叶多见,临床表现及胸部影像学改变与其他类型肺癌相似。病理类型:10例为肉瘤样癌伴上皮癌成分混合组成,其中上皮癌成分包括腺癌、大细胞癌、鳞癌及细支气管肺泡癌;其余7例为单一肉瘤样癌。免疫组化示:波纹蛋白(Vimentin)阳性11例,细胞角质蛋白(CK)阳性8例,抗细胞角蛋白单克隆抗体3(AE3)阳性4例,抗细胞角蛋白单克隆抗体1(AE1)阳性3例,上皮细胞膜抗原(EMA)阳性2例。结论PSC确诊需要病理组织学检查,免疫组织化学Vimentin、CK、AE1/AE3及EMA有助于确诊。

The clinical and pathological features of pulmonary sarcomatoid carcinoma: 17 cases review

Objective To review the clinical and pathological features of pulmonary sarcomatoid carcinoma(PSC).Methods Clinical and pathologic data of 17 patients with PSC,which defined diagnosis with pathology,were reviewed.Results It showed that PSC mostly involved the upper lobe of right lung.The clinical manifestations and chest imaging of PSC were similar to that of other types of non small cell lung carcinomas(NSCLC).Multiphasic PSC was mixed with epithelial component of carcinomas(including adenocarcinoma,giant cell carcinoma,squamous cell carcinoma and bronchioalveolar carcinoma) and sarcomatoid carcinoma(SC) in 10 patients.Monophasic PSC was entirely SC in other 7 patients.The immunohistochemical results showed that Vimentin was detected in 11 cases,CK was positive in 8 cases,AE3 was positive in 4 cases and AE1 was positive in 3 cases,EMA was positive in 2 cases.Conclusion It showed that the final diagnosis of PSC was based on histopathology.The immunohistochemical staining of Vimentin,CK,AE1/AE3 and EMA may be helpful for diagnosis.