Primary sarcomatoid carcinoma of the lung

Last revised by Yuranga Weerakkody on 30 Jul 2023

Primary sarcomatoid carcinomas of the lung refer to a heterogeneous group of rare and poorly differentiated types of non-small cell lung carcinomas (NSCLC).

They are thought to account for 0.2 to 1% of all lung cancers 1. Sarcomatoid histology may be present in 0.1-0.4% of non-small cell lung cancers 3

They are poorly differentiated non-small cell cancers that contain a sarcoma or sarcoma-like component. They are the most common pulmonary neoplasms that exhibit a composition by spindled or pleomorphic tumor cells. Due to this reason, they may be confused easily with true sarcomas diagnostically unless special immunohistological or ultrastructural analyzes are performed.

Specific subgroups that have been classified under sarcomatoid carcinomas of the lungs include 4,6:

While some publications suggest a poorer prognosis with sarcomatoid histology 3 although this fact appears to be debatable according to other publications 1.

If sarcomatoid histology is revealed following a biopsy for a lung lesion, differentials to consider include 7:

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