Sarcomatoid carcinoma of the lung other diagnostic studies
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Sarcomatoid Carcinoma of the Lung Microchapters |
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Differentiating Sarcomatoid Carcinoma of the Lung from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]
Overview
The definitive diagnosis of sarcomatoid carcinoma of the lung is made by immunohistochemical analysis and pathological subtyping of the specimen collected from biopsy, needle aspiration, sputum cytology or surgical resection of the tumor. Specimen for immunohistochemical analysis and pathological subtyping may be collected by transthoracic needle biopsy, bronchoscopy with biopsy, surgical resection, video-assisted thoracoscopic surgery (VATS), endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) and rarely sputum cytology.
Other Diagnostic Studies
The definitive diagnosis of sarcomatoid carcinoma of the lung is made by immunohistochemical analysis and pathological subtyping of the specimen collected from biopsy, needle aspiration, sputum cytology or surgical resection of the tumor.[1]
- Specimen for immunohistochemical analysis and pathological subtyping may be collected by transthoracic needle biopsy, bronchoscopy with biopsy, surgical resection, video-assisted thoracoscopic surgery (VATS), endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) and rarely sputum cytology.
Biopsy
- Biopsy findings associated with sarcomatoid carcinoma of the lung will depend on the histopathological subtypes.[2]
- For more information, see microscopic pathology.
Immunohistochemical Staining
- Sarcomatoid carcinoma of lung may be positive for the following immunohistochemical markers: [3][4]
- CAM5.2
- CK7
- Thyroid transcription factor 1(TTF-1)
- Napsin A
- AE1/AE3
- WT1
- calretinin
- Sox2
- CK5/6
- p40
- S-100
- desmin
- SMAD2-40
- Desmocollin 3
- Pleomorphic, spindle and/or giant cell carcinoma may show findings positive for component of squamous cell carcinoma, adenocarcinoma, or large cell carcinoma.
- In case of poorly differentiated pleomorphic, spindle and/or giant cell carcinoma markers for epithelial components such as keratin antibodies and EMA (epithelial membrane marker).
- Pleomorphic, spindle and/or giant cell carcinoma may also be positive for cytokeratin, vimentin, carcinoembryonic antigen, and smooth muscle markers.
- Giant cell carcinomas may be positive for TTF-1.
- Carcinosarcomas may be positive for keratin antibodies.
- Variants of carcinosarcoma subtype such as chondrosarcoma may be positive for S-100 protein and rhabdomyosarcoma for muscle markers.
References
- ↑ Roesel, Christian; Terjung, Sarah; Weinreich, Gerhard; Hager, Thomas; Chalvatzoulis, Eleftherios; Metzenmacher, Martin; Welter, Stefan (2016). "Sarcomatoid carcinoma of the lung: a rare histological subtype of non-small cell lung cancer with a poor prognosis even at earlier tumour stages". Interactive CardioVascular and Thoracic Surgery: ivw392. doi:10.1093/icvts/ivw392. ISSN 1569-9293.
- ↑ Sobin LH (1981). "The international histological classification of tumours". Bull. World Health Organ. 59 (6): 813–9. PMC 2396133. PMID 6978190.
- ↑ Weissferdt A, Kalhor N, Rodriguez Canales J, Fujimoto J, Wistuba II, Moran CA (January 2017). "Spindle cell and pleomorphic ("sarcomatoid") carcinomas of the lung: an immunohistochemical analysis of 86 cases". Hum. Pathol. 59: 1–9. doi:10.1016/j.humpath.2016.08.003. PMID 27569293.
- ↑ Terra SB, Aubry MC, Yi ES, Boland JM (February 2014). "Immunohistochemical study of 36 cases of pulmonary sarcomatoid carcinoma--sensitivity of TTF-1 is superior to napsin". Hum. Pathol. 45 (2): 294–302. doi:10.1016/j.humpath.2013.09.005. PMID 24331839.