Large pleomorphic carcinoma of the lung: A case report

Publication date: June 2019Source: Human Pathology: Case Reports, Volume 16Author(s): Rusella Mirza, Mingxia ShiAbstractPleomorphic carcinoma (PC) of the lung is an aggressive carcinoma and an extremely rare entity. It is one of the subtypes of pulmonary sarcomatoid carcinoma. We are presenting a case of large PC with the relevant histological, immunohistochemical and molecular studies. A surgical specimen of a lung mass was obtained from a 74 year old female patient. The mass was 11 cm in its greatest dimension and was firmly attached to the pleura and diaphragm. Grossly the tumor was infiltrating to the surrounding structure. Microscopically the tumor was composed predominantly of spindle cells with small areas of epithelial nests, bizarre pleomorphic cells and tumor giant cells. The tumor was hypercellular and actively proliferating. The neoplastic spindle cells were strongly positive with vimentin and caldesmon, while the malignant epithelial cells showed positivity with AE1/AE3 and CK5/6. Tumor cells did not stain for TTF-1, napsin-A, synaptophysin, Cam5.2, CD34, SOX-10 and S-100. Based on the recent WHO classification of sarcomatoid neoplasm of the lung, our case was defined as a pleomorphic carcinoma of the lung. Molecular testing was negative for PD-L1, EGFR and Alk1. For this patient, a diagnosis of spindle cell neoplasm favoring sarcoma was rendered by prior needle biopsy at an outside hospital. Here we demonstrate that liberal sampling together with proper immu...
Source: Human Pathology: Case Reports - Category: Pathology Source Type: research