Lung sarcoma (carcinosarcoma) is a highly malignant tumors, lung cancer is rare. Tumor tissue from non-small cell carcinoma and one by one heterologous compositions, such as cartilage sarcoma sarcoma, osteosarcoma, rhabdomyosarcoma. If the lack of heterologous sarcoma component is attributable to pleomorphic carcinoma.
Carcinosarcoma of the general introduction (1) gross appearance: most located in the hilar tumor, accounting for 75%; while 25% of peripheral lung. Those in the hilar tumor to the bronchial lumen and more sudden, early symptoms — cough, bloody sputum and bronchial infections obvious; while those in the peripheral, because the early lack of clinical symptoms, when the invading into adjacent tissues or organs caused by the corresponding clinical symptoms, tumor is often larger. Tumor section without capsule, ill-defined; white or was fish-like, often accompanied by hemorrhage, necrosis was reddish brown or greyish yellow.
Carcinosarcoma of the general introduction (2) microscopic features: epithelial tumors, including malignant and malignant mesenchymal component composition.
malignant epithelial component: the more common squamous cell carcinoma, adenocarcinoma, followed by; adenosquamous carcinoma, large cell carcinoma, spindle cell carcinoma is uncommon.
malignant asked leaf component (sarcoma): heterogeneity of lung sarcomas the frequency, from highest to lowest, were: osteosarcoma, chondrosarcoma, rhabdomyosarcoma. Most of these ingredients mixed sarcoma of the form. Among them, osteosarcoma and chondrosarcoma the most common mixed; followed by sarcoma of the three components exist. Carcinosarcoma of the organizational structure is complex, and often accompanied by necrosis. So keep bronchoscopy or percutaneous puncture of small samples, not easy to diagnose. Finally diagnosed from surgical specimens and autopsy.
Carcinosarcoma of the general introduction (3) the histological diagnosis of cancer, sarcoma: diagnostic criteria based on its small, but one by one poorly differentiated carcinoma and non-heterologous sarcoma components co-exist, diagnosis is not difficult. In order to confirm the cancer of the proposed cytokeratin, EMA and CEA in combination. Because the test results recorded against a single epithelium, can not fully reflect the authenticity of the tumor epithelial differentiation. Carcinosarcoma in the poorly differentiated striated muscle component in the conventional light microscope is difficult to determine.
Determine the cancer tissue sarcoma rhabdomyosarcoma contain ingredients, do they listen to binding protein and white combined muscle testing, if the expression was the same time, you can confirm the tumor tissue with stripes tumor components. Spindle cell components, to do electron microscopy can confirm that more sources of tumor differentiation. If it is found in cancer tissue sarcoma, small cell carcinoma of the ingredients, then known as compound of small cells.
Carcinosarcoma of the general introduction (4) differential diagnosis
malignant teratoma (malignant teratoma): mediastinal malignant teratoma, composition and structure of epithelial malignant asked leaf components. Therefore, similar to lung sarcoma. It should be noted on the identification of: a. the location of the primary tumor: malignant mediastinal teratoma originating in the mediastinum, the surrounding, the main tumor located in the mediastinum; and lung sarcoma, can be primary in the hilar bronchus, separated from the bronchial and peripheral lung from substantial expansion of the primary tumor located in the large bronchial lumen; b. Early symptoms: hilar lung cancer sarcoma, due to the bronchial lumen obstruction, so you can appear in early clinical are like, smaller tumor size at this time; mediastinal malignant teratoma primary in the mediastinum, the mediastinal structure characteristics, tumor size smaller, not clinical symptoms, when the clinical symptoms, the tumor volume is quite large, around the violation has also been a significant exception; c. age of onset and regular habits teratoma is a congenital, age of onset less; lung sarcoma more common in older men who smoke; d. Organization: malignant teratoma component complex. Common are the glandular epithelium is epithelium, fibrous tissue, muscle tissue, bone and cartilage, nerve tissue also can occur, and air elements appear one by one the reproductive system tumor choriocarcinoma, seminoma, embryonic: the pain and the Yolk sac tumor and so on. Sarcoma of lung cancer is relatively simple components, from non-small cell carcinoma and sarcoma composed of different origin.
pulmonary pleomorphic carcinoma: The main point is to identify whether there is heterogeneity in tumor tissue sarcoma. Pleomorphic carcinoma of the lung showed mixed poorly differentiated non-small cell carcinoma and sarcoma components homology; lung sarcoma was mixed with non-small cell carcinoma of the heterologous sarcoma.
Carcinosarcoma of the general introduction (5) prognosis: Lung cancer is highly malignant sarcoma. Surgery plus chemotherapy, radiotherapy, is the conventional treatment; but the prognosis is poor.