Clinical Analysis Of Pleomorphic Carcinoma Of The Lung And Review Of Literatures (Report Of1Case)

Objective:To evaluate the clinical manifestation, diagnosis, treatment, and analyze prognosis of lung pleomorphic carcinoma. To improve our knowledge of this disease.Methods:Report one case of plemorphic carcinoma of lung treated in the Thoracic Surgery Department of Ji’nan Central Hospital Affiliated to Shandong University. Use" pleomorphic carcinoma, lung" as the key words to search in CNKI database, Wanfang database, Elsevier ScienceDirect and Medline. Eliminate the duplicate cases and that have little details.Results:In the108PCL cases,90(83.3%) are male and18(16.7%) are female. The age of patients range from35to81years with the average age of63years. Among82cases described smoking history,66cases’ smoking history are more than10pack year. The clinical manifestations of PCL are similar to other types of NSCLC.72.73%of55cases have obvious symptoms which is frequent in cough (54.55%), hemoptysis (45.45%) and chest pain (25.45%). And we have one male patient with high serum βhCG level and gynecomastia.17of59cases (28.8%) are central type while the rest of them (71.2%) are peripheral type. The amount of right lung lesion and upper lobe lesion are both27(64.3) of42cases. The main auxiliary examinations of PCL include chest X-ray, chest computed tomography, PET, sputum cytology, transbronchial lung biopsy and percutaneous needle aspiration cytology. The definite diagnosis of pleomorphic carcinoma depends on pathology and immunohistochemical staining. The epithelioid components and sarcomatoid components are seen simultaneously through microscope. The epithelioid components are squamous cell carcinoma, adenocarcinoma and large cell carcinoma. The sarcomatoid components are spindle cell and giant cell. The immunohistochemical staining of PCL reveals that CK (+) and vimentin (+).Conclusions:Pleomorphic carcinoma of lung is a rare lung cancer. It is more common in male patients with long smoking histories. The lesions usually locate peripherally with a large capacity. The right lung lesion and upper lobe lesion are more common. It has a aggressive character and easy to invade the peripheral tissue. The clinical manifestations and imaging findings are not special to the common NSCLC. The SUVmax is obviously high than that of other NSCLC in PET. The definite diagnosis of pleomorphic carcinoma depends on pathology and immunohistochemical staining. The tissue of PCL consist of epithelioid and sarcomatoid components. The sarcomatoid cells should comprise at least10%of the tumour. Upon diagnosis, patients should have operations immediately. Chemotherapy or radiotherapy is essential after the surgery. PCL is a highly malignant lung cancer with high recurrence rate, high metastasis rate and poor prognosis. Molecular targeted therapy may has active responding. The prognosis has something to do with tumor size, histological type, differentiation degree and clinical stage.