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Sarcomatoid carcinoma of the lung

January 01, 1970

Sarcomatoid carcinoma of the lung is a term that encompasses five distinct histological subtypes of lung cancer, including (1) pleomorphic carcinoma, (2) spindle cell carcinoma, (3) giant cell carcinoma, (4) carcinosarcoma, or (5) pulmonary blastoma.[1]

Sarcomatoid carcinoma of the lung
SpecialtyOncology/pulmonology

Genetics edit

Abnormal duplication of the EGFR gene is a relatively infrequent phenomenon in SCL (>/= 4 copies in >/= 40% of cells in 5/22).[2]

Overexpression of the EGFR protein occurs in nearly all cases (22/22).[2]

Mutations of the EGFR gene are relatively rare (0/23).[2]

K-ras mutations found in 8/22 cases (Gly12Cys in 6 cases and Gly12Val in 2 cases).[2]

SCL show intense immune infiltration which is predominantly neutrophillic. However the tumors evade the immune system by increased expression of a negative regulator of T-cells mainly programmed death ligand-1.[3]

Diagnosis edit

Classification edit

Lung cancer is a large and exceptionally heterogeneous family of malignancies.[4] Over 50 different histological variants are explicitly recognized within the 2004 revision of the World Health Organization (WHO) typing system ("WHO-2004"), currently the most widely used lung cancer classification scheme.[1] Many of these entities are rare, recently described, and poorly understood.[5] However, since different forms of malignant tumors generally exhibit diverse genetic, biological, and clinical properties, including response to treatment, accurate classification of lung cancer cases are critical to assuring that patients with lung cancer receive optimum management.[6][7]

Approximately 98% of lung cancers are carcinoma, a term for malignant neoplasms derived from cells of epithelial lineage, and/or that exhibit cytological or tissue architectural features characteristically found in epithelial cells.[8] Under WHO-2004, lung carcinomas are divided into 8 major taxa:[1]

Sarcomatoid carcinomas are unique among lung carcinomas in that, although they are considered carcinomas, they contain cytological and tissue architectural features that are usually characteristic of sarcoma.[1]

Treatment edit

Because these tumors are so rare, there have been no randomized clinical trials yet conducted with respect to specific treatment regimens for any subtype.[9][10]

Very few histospecific studies of individual subtypes SCL have been published in the literature; most data has been small retrospective case series or case reports.

In many cases, SCL are generally treated like other NSCLC. However, as SCL are considered particularly aggressive non-small cell lung cancers,[2] some experts recommend particularly aggressive treatment approach to these tumors.

Little is known about the effects of EGFR inhibitors in SC, although some evidence suggests that these tumors are not likely to be highly responsive.[2]

Prognosis edit

As a group, SCL prognosis is considered to be worse than that of most types of NSCLC.[citation needed]

References edit

  1. ^ a b c d Travis, William D; Brambilla, Elisabeth; Muller-Hermelink, H Konrad; et al., eds. (2004). Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart (PDF). World Health Organization Classification of Tumours. Lyon: IARC Press. ISBN 978-92-832-2418-1. Retrieved 27 March 2010.
  2. ^ a b c d e f Italiano A, Cortot AB, Ilie M, et al. (November 2009). "EGFR and KRAS status of primary sarcomatoid carcinomas of the lung: implications for anti-EGFR treatment of a rare lung malignancy". Int. J. Cancer. 125 (10): 2479–82. doi:10.1002/ijc.24610. PMID 19681124. S2CID 205938398.
  3. ^ Velcheti, V.; Rimm, D. L.; Schalper, K. A. (2013). "Sarcomatoid Lung Carcinomas Show High Levels of Programmed Death Ligand-1 (PD-L1)". Journal of Thoracic Oncology. 8 (6): 803–805. doi:10.1097/JTO.0b013e318292be18. PMC 3703468. PMID 23676558.
  4. ^ Roggli VL, Vollmer RT, Greenberg SD, McGavran MH, Spjut HJ, Yesner R (June 1985). "Lung cancer heterogeneity: a blinded and randomized study of 100 consecutive cases". Hum. Pathol. 16 (6): 569–79. doi:10.1016/S0046-8177(85)80106-4. PMID 2987102.
  5. ^ Brambilla E, Travis WD, Colby TV, Corrin B, Shimosato Y (December 2001). "The new World Health Organization classification of lung tumours". Eur. Respir. J. 18 (6): 1059–68. doi:10.1183/09031936.01.00275301. PMID 11829087.
  6. ^ Rossi G, Marchioni A, Sartori1 G, Longo L, Piccinini S, Cavazza A (2007). "Histotype in non-small cell lung cancer therapy and staging: The emerging role of an old and underrated factor". Curr Respir Med Rev. 3: 69–77. doi:10.2174/157339807779941820.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
  7. ^ Vincent MD (August 2009). "Optimizing the management of advanced non-small-cell lung cancer: a personal view". Curr Oncol. 16 (4): 9–21. doi:10.3747/co.v16i4.465. PMC 2722061. PMID 19672420.
  8. ^ Travis WD, Travis LB, Devesa SS (January 1995). "Lung cancer". Cancer. 75 (1 Suppl): 191–202. doi:10.1002/1097-0142(19950101)75:1+<191::AID-CNCR2820751307>3.0.CO;2-Y. PMID 8000996. S2CID 34718856.
  9. ^ National Library of Medicine. Available at http://www.pubmed.com 13 February 2015 at the Wayback Machine
  10. ^ National Institutes of Health. Clinical Trials Search Engine. Available at http://www.clinicaltrials.gov/ct2/results?term=sarcomatoid+carcinoma

External links edit

  • Lung Cancer Home Page. The National Cancer Institute site containing further reading and resources about lung cancer.
  • World Health Organization Histological Classification of Lung and Pleural Tumours. 4th Edition

January 01, 1970
sarcomatoid, carcinoma, lung, term, that, encompasses, five, distinct, histological, subtypes, lung, cancer, including, pleomorphic, carcinoma, spindle, cell, carcinoma, giant, cell, carcinoma, carcinosarcoma, pulmonary, blastoma, specialtyoncology, pulmonolog. Sarcomatoid carcinoma of the lung is a term that encompasses five distinct histological subtypes of lung cancer including 1 pleomorphic carcinoma 2 spindle cell carcinoma 3 giant cell carcinoma 4 carcinosarcoma or 5 pulmonary blastoma 1 Sarcomatoid carcinoma of the lungSpecialtyOncology pulmonology Contents 1 Genetics 2 Diagnosis 2 1 Classification 3 Treatment 4 Prognosis 5 References 6 External linksGenetics editAbnormal duplication of the EGFR gene is a relatively infrequent phenomenon in SCL gt 4 copies in gt 40 of cells in 5 22 2 Overexpression of the EGFR protein occurs in nearly all cases 22 22 2 Mutations of the EGFR gene are relatively rare 0 23 2 K ras mutations found in 8 22 cases Gly12Cys in 6 cases and Gly12Val in 2 cases 2 SCL show intense immune infiltration which is predominantly neutrophillic However the tumors evade the immune system by increased expression of a negative regulator of T cells mainly programmed death ligand 1 3 Diagnosis editClassification edit Lung cancer is a large and exceptionally heterogeneous family of malignancies 4 Over 50 different histological variants are explicitly recognized within the 2004 revision of the World Health Organization WHO typing system WHO 2004 currently the most widely used lung cancer classification scheme 1 Many of these entities are rare recently described and poorly understood 5 However since different forms of malignant tumors generally exhibit diverse genetic biological and clinical properties including response to treatment accurate classification of lung cancer cases are critical to assuring that patients with lung cancer receive optimum management 6 7 Approximately 98 of lung cancers are carcinoma a term for malignant neoplasms derived from cells of epithelial lineage and or that exhibit cytological or tissue architectural features characteristically found in epithelial cells 8 Under WHO 2004 lung carcinomas are divided into 8 major taxa 1 Squamous cell carcinoma Small cell carcinoma Adenocarcinoma Large cell carcinoma Adenosquamous carcinoma Sarcomatoid carcinoma Carcinoid tumor Salivary gland like carcinoma Sarcomatoid carcinomas are unique among lung carcinomas in that although they are considered carcinomas they contain cytological and tissue architectural features that are usually characteristic of sarcoma 1 Treatment editBecause these tumors are so rare there have been no randomized clinical trials yet conducted with respect to specific treatment regimens for any subtype 9 10 Very few histospecific studies of individual subtypes SCL have been published in the literature most data has been small retrospective case series or case reports In many cases SCL are generally treated like other NSCLC However as SCL are considered particularly aggressive non small cell lung cancers 2 some experts recommend particularly aggressive treatment approach to these tumors Little is known about the effects of EGFR inhibitors in SC although some evidence suggests that these tumors are not likely to be highly responsive 2 Prognosis editAs a group SCL prognosis is considered to be worse than that of most types of NSCLC citation needed References edit a b c d Travis William D Brambilla Elisabeth Muller Hermelink H Konrad et al eds 2004 Pathology and Genetics of Tumours of the Lung Pleura Thymus and Heart PDF World Health Organization Classification of Tumours Lyon IARC Press ISBN 978 92 832 2418 1 Retrieved 27 March 2010 a b c d e f Italiano A Cortot AB Ilie M et al November 2009 EGFR and KRAS status of primary sarcomatoid carcinomas of the lung implications for anti EGFR treatment of a rare lung malignancy Int J Cancer 125 10 2479 82 doi 10 1002 ijc 24610 PMID 19681124 S2CID 205938398 Velcheti V Rimm D L Schalper K A 2013 Sarcomatoid Lung Carcinomas Show High Levels of Programmed Death Ligand 1 PD L1 Journal of Thoracic Oncology 8 6 803 805 doi 10 1097 JTO 0b013e318292be18 PMC 3703468 PMID 23676558 Roggli VL Vollmer RT Greenberg SD McGavran MH Spjut HJ Yesner R June 1985 Lung cancer heterogeneity a blinded and randomized study of 100 consecutive cases Hum Pathol 16 6 569 79 doi 10 1016 S0046 8177 85 80106 4 PMID 2987102 Brambilla E Travis WD Colby TV Corrin B Shimosato Y December 2001 The new World Health Organization classification of lung tumours Eur Respir J 18 6 1059 68 doi 10 1183 09031936 01 00275301 PMID 11829087 Rossi G Marchioni A Sartori1 G Longo L Piccinini S Cavazza A 2007 Histotype in non small cell lung cancer therapy and staging The emerging role of an old and underrated factor Curr Respir Med Rev 3 69 77 doi 10 2174 157339807779941820 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link CS1 maint numeric names authors list link Vincent MD August 2009 Optimizing the management of advanced non small cell lung cancer a personal view Curr Oncol 16 4 9 21 doi 10 3747 co v16i4 465 PMC 2722061 PMID 19672420 Travis WD Travis LB Devesa SS January 1995 Lung cancer Cancer 75 1 Suppl 191 202 doi 10 1002 1097 0142 19950101 75 1 lt 191 AID CNCR2820751307 gt 3 0 CO 2 Y PMID 8000996 S2CID 34718856 National Library of Medicine Available at http www pubmed com Archived 13 February 2015 at the Wayback Machine National Institutes of Health Clinical Trials Search Engine Available at http www clinicaltrials gov ct2 results term sarcomatoid carcinomaExternal links editLung Cancer Home Page The National Cancer Institute site containing further reading and resources about lung cancer World Health Organization Histological Classification of Lung and Pleural Tumours 4th Edition Retrieved from https en wikipedia org w index php title Sarcomatoid carcinoma of the lung amp oldid 1179716141, wikipedia, wiki, book, books, library,

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