Pleomorphic carcinoma of the lung is a rare type of lung tumour. They are classified under sarcomatoid carcinomas of the lungs.
These tumours are thought to account for 0.1-0.4% of all lung malignancies.
There is a recognised association with smoking.
Histologically, a pleomorphic carcinoma is defined as either
- a non–small cell lung carcinoma combined with neoplastic spindle and/or giant cells
- 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.
There no published specific imaging features for this histological subtype. Most CT features are thought to be dependent on the epithelial component of the tumour 5.
The tumours can be either endobronchial (central) or peripheral (the latter location is considered commoner 1,7). They can frequently involve the pleural and/or chest wall. Larger tumours may show central low attenuation. Some publications suggest an upper lobe predilection 5. While many can be well-defined, some can be lobulated, ill-defined or even spiculated 5.
Treatment and prognosis
A spindle cell histology is generally associated with a more aggressive clinical course 3,4. The presence of pleural invasion is associated with a much worse prognosis 7.
- 1. Kim TH, Kim SJ, Ryu YH et-al. Pleomorphic carcinoma of lung: comparison of CT features and pathologic findings. Radiology. 2004;232 (2): 554-9. Radiology (full text) - doi:10.1148/radiol.2322031201 - Pubmed citation
- 2. Fishback NF, Travis WD, Moran CA et-al. Pleomorphic (spindle/giant cell) carcinoma of the lung. A clinicopathologic correlation of 78 cases. Cancer. 1994;73 (12): 2936-45. Pubmed citation
- 3. Mochizuki T, Ishii G, Nagai K et-al. Pleomorphic carcinoma of the lung: clinicopathologic characteristics of 70 cases. Am. J. Surg. Pathol. 2008;32 (11): 1727-35. doi:10.1097/PAS.0b013e3181804302 - Pubmed citation
- 4. Bae HM, Min HS, Lee SH et-al. Palliative chemotherapy for pulmonary pleomorphic carcinoma. Lung Cancer. 2007;58 (1): 112-5. doi:10.1016/j.lungcan.2007.05.006 - Pubmed citation
- 5. Kim TS, Han J, Lee KS et-al. CT findings of surgically resected pleomorphic carcinoma of the lung in 30 patients. AJR Am J Roentgenol. 2005;185 (1): 120-5. doi:10.2214/ajr.185.1.01850120 - Pubmed citation
- 6. Yuki T, Sakuma T, Ohbayashi C et-al. Pleomorphic carcinoma of the lung: a surgical outcome. J. Thorac. Cardiovasc. Surg. 2007;134 (2): 399-404. doi:10.1016/j.jtcvs.2007.04.018 - Pubmed citation
- 7. Chen F, Sonobe M, Sato T et-al. Clinicopathological characteristics of surgically resected pulmonary pleomorphic carcinoma. Eur J Cardiothorac Surg. 2012;41 (5): 1037-42. Eur J Cardiothorac Surg (full text) - doi:10.1093/ejcts/ezr136 - Pubmed citation
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