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Pulmonary carcinosarcoma: immunohistochemical and ultrastructural studies
S Haraguchi1, Y Fukuda, Y Sugisaki
1Department of Pathology, Nippon Medical School, Tokyo, Japan.
Pathology International
|November 26, 1999
Summary
Pulmonary carcinosarcoma, a rare lung cancer, presents a unique case where cancer cells exhibit both epithelial and mesenchymal traits. This study suggests the sarcomatous component may arise from the carcinomatous part.
Area of Science:
- Pulmonary pathology
- Oncology
- Cancer cell biology
Background:
- Pulmonary carcinosarcoma is an exceptionally rare malignant lung tumor.
- This report details a specific case in a 68-year-old male, focusing on its unique pathological characteristics.
Observation:
- The tumor predominantly grew endobronchially, invading bronchial structures.
- Histologically, it comprised poorly differentiated squamous cell carcinoma (carcinomatous component) and chondrosarcoma (sarcomatous component).
- Immunohistochemical and ultrastructural analyses revealed dual epithelial and mesenchymal features in the sarcomatous cells.
Findings:
- The sarcomatous component cells expressed S-100 protein and were embedded in an Alcian blue-positive matrix.
- Both carcinomatous and sarcomatous cells reacted with anti-epithelial membrane antigen antibody.
- Ultrastructural examination showed epithelial features (tonofibrils, desmosomes) in carcinomatous cells and mesenchymal features (dilated rough endoplasmic reticulum, myxomatous matrix) in sarcomatous cells, with some overlap.
Implications:
- This is the first study to demonstrate ultrastructurally and immunohistochemically that sarcomatous cells in pulmonary carcinosarcoma possess both epithelial and mesenchymal characteristics.
- The findings suggest a possible metaplastic or transdifferentiation origin of the sarcomatous component from the carcinomatous component.
- This case contributes to understanding the complex cellular origins and behavior of pulmonary carcinosarcomas.