Pleomorphic carcinoma of lung
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These tumors are thought to account for 0.1-0.4% of all lung malignancies.
There is a recognized 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 tumor 5.
The tumors 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 tumors 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.
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