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Pulmonary carcinomas with a sarcomatoid element: an immunocytochemical and ultrastructural analysis.

Publication ,  Journal Article
Humphrey, PA; Scroggs, MW; Roggli, VL; Shelburne, JD
Published in: Hum Pathol
February 1988

Eight primary carcinomas of the lung with a prominent spindle-cell sarcomatoid component were studied by immunocytochemical staining and electron microscopy. The eight tumors were indistinguishable by conventional light microscopy, with the exception of one unusual neoplasm that followed multiple pathways of differentiation with elements of squamous cell carcinoma, rhabdomyosarcoma, chondrosarcoma, and an undifferentiated spindle-cell population. Reticulin fiber production by individual spindle cells and a sharp demarcation of the carcinomatous and sarcomatoid domains by light microscopy were not useful differentiating features. Three of the eight tumors exhibited keratin expression in both the carcinomatous and spindle-cell components. Both immunocytochemical and electron microscopic analyses were required to detect epithelial differentiation, as in one case keratin was identified only by immunocytochemical staining and in another only by ultrastructural examination. Epithelial differentiation was undetectable in the sarcomatoid component of five tumors, and in one case immunoreactive myoglobin was identified in spindle cells; skeletal muscle differentiation was confirmed ultrastructurally. We propose that pulmonary carcinomas exhibiting evidence of epithelial differentiation in a sarcomatoid component be termed spindle-cell carcinomas and that those biphasic tumors exhibiting mesenchymal differentiation into specific tissues, such as neoplastic bone, cartilage, or striated muscle, or lacking epithelial differentiation by light microscopy, immunocytochemistry, and electron microscopy be classified as carcinosarcomas. This distinction may ultimately be unnecessary, because these two tumors may represent different points along a morphologic and biologic continuum.

Duke Scholars

Published In

Hum Pathol

DOI

ISSN

0046-8177

Publication Date

February 1988

Volume

19

Issue

2

Start / End Page

155 / 165

Location

United States

Related Subject Headings

  • Sarcoma
  • Pathology
  • Microscopy, Electron
  • Male
  • Lung Neoplasms
  • Keratins
  • Immunohistochemistry
  • Humans
  • Female
  • Carcinoma
 

Citation

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Humphrey, P. A., Scroggs, M. W., Roggli, V. L., & Shelburne, J. D. (1988). Pulmonary carcinomas with a sarcomatoid element: an immunocytochemical and ultrastructural analysis. Hum Pathol, 19(2), 155–165. https://doi.org/10.1016/s0046-8177(88)80343-5
Humphrey, P. A., M. W. Scroggs, V. L. Roggli, and J. D. Shelburne. “Pulmonary carcinomas with a sarcomatoid element: an immunocytochemical and ultrastructural analysis.Hum Pathol 19, no. 2 (February 1988): 155–65. https://doi.org/10.1016/s0046-8177(88)80343-5.
Humphrey PA, Scroggs MW, Roggli VL, Shelburne JD. Pulmonary carcinomas with a sarcomatoid element: an immunocytochemical and ultrastructural analysis. Hum Pathol. 1988 Feb;19(2):155–65.
Humphrey, P. A., et al. “Pulmonary carcinomas with a sarcomatoid element: an immunocytochemical and ultrastructural analysis.Hum Pathol, vol. 19, no. 2, Feb. 1988, pp. 155–65. Pubmed, doi:10.1016/s0046-8177(88)80343-5.
Humphrey PA, Scroggs MW, Roggli VL, Shelburne JD. Pulmonary carcinomas with a sarcomatoid element: an immunocytochemical and ultrastructural analysis. Hum Pathol. 1988 Feb;19(2):155–165.
Journal cover image

Published In

Hum Pathol

DOI

ISSN

0046-8177

Publication Date

February 1988

Volume

19

Issue

2

Start / End Page

155 / 165

Location

United States

Related Subject Headings

  • Sarcoma
  • Pathology
  • Microscopy, Electron
  • Male
  • Lung Neoplasms
  • Keratins
  • Immunohistochemistry
  • Humans
  • Female
  • Carcinoma