Approaches to Tumor Classification in Pulmonary Sarcomatoid Carcinoma.
PD-L1
WHO
c-MET
carcinoma
cytokeratins
immunohistochemistry
sarcomatoid
Journal
Lung Cancer (Auckland, N.Z.)
ISSN: 1179-2728
Titre abrégé: Lung Cancer (Auckl)
Pays: New Zealand
ID NLM: 101632521
Informations de publication
Date de publication:
2019
2019
Historique:
received:
27
07
2019
accepted:
26
11
2019
entrez:
12
12
2019
pubmed:
12
12
2019
medline:
12
12
2019
Statut:
epublish
Résumé
Pulmonary sarcomatoid carcinoma (PSC) is a heterogeneous category of primary lung cancer accounting from 0.3% to 3% of all primary lung malignancies. According to the most recent 2015 World Health Organization (WHO) classification, PSC includes several different variants of malignant epithelial tumors (carcinomas) histologically mimicking sarcomas showing or entirely lacking a conventional component of non-small cell lung cancer (NSCLC). Thus, this rare subheading of lung neoplasms includes pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, pulmonary blastoma, and carcinosarcoma. A diagnosis of PSC may be suspected on small biopsy or cytology, but commonly requires a surgical resection to reach a conclusive definition. The majority of patients with PSC consists of elderly, smoking men with a large, peripheral mass characterized by well-defined margins. However, presentation with a central, polypoid endobronchial lesion is well-documented, particularly in pleomorphic carcinoma and carcinosarcoma showing a squamous cell carcinoma component. As expected, PSC may pose diagnostic problems and immunohistochemistry is largely used when pathologists deal these tumors in routine practice. Indeed, PSC tends to overexpress molecules associated with the epithelial-to-mesenchymal transition, such as vimentin, but the panel of immunostains also includes epithelial markers (cytokeratins, EMA), TTF-1, p40 and negative markers (e.g., melanocytic, mesothelial and sarcoma-related primary antibodies). Although rare, PSC has increased their interest among oncologist community for different reasons: a. identification of the epithelial-to-mesenchymal phenomenon as a major mechanism of secondary resistance to tyrosine kinase inhibitors; b. over-expression of PD-L1 and effective treatment with immunotherapy; c. identification of
Identifiants
pubmed: 31824199
doi: 10.2147/LCTT.S186779
pii: 186779
pmc: PMC6901065
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
131-149Informations de copyright
© 2019 Baldovini et al.
Déclaration de conflit d'intérêts
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
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