Table 1.
Sarcoma components, non-pulmonary sarcoma components, genetic characteristics, and immunohistochemistry of PSC.
| classification | Components | Immunohistochemistry | |
|---|---|---|---|
| Pleomorphic carcinoma (PC) |
NSCLCs:
adenocarcinoma, squamous-cell carcinoma, adenosquamous-cell carcinoma, and large-cell undifferentiated carcinoma |
Sarcoma:
sarcoma-like components usually make up at least 10% of the tumor tissue and are composed of spindle or giant cells, either of the two, or a mixture of the two |
Typical representative:
CKs (CK5/6, CK, CK7, CK14,
CK18, CK19), EMA, TTF-1
and Naspin (in case of adenocarcinoma
differentiation), P40 and
high-molecular-weight CKs (in case of
squamous-cell carcinoma) Others: composition expression of: (1) squamous-cell carcinoma and adenocarcinoma: PCK, SPA (+) (2) sarcoma cells: vimentin (+) constantly, CK(+) focally, S-100, desmin, α-SMA, CD117 and PDGF-α(–) |
| Spindle-cell carcinoma | Malignant spindle cells are usually composed of spindle molecules and eosinophilic cytoplasm, arranging in bundles sheets |
Typical representative:
CKs (CK, CK5/6, CK7, CK14,
CK18, CK19, CK20), EMA,
TTF-1 and napsin (in case
of adenocarcinoma differentiation), P40
and high-molecular-weight CKs (in case
of squamous-cell carcinoma) Others: PCK, vimentin, P53(+) strongly, P63(+), Ki-67:70~90% Desmin, S-100, α-SMA, CD34 and CD117(–) |
|
| Giant-cell carcinoma | The cancer cells are composed of large, highly pleomorphic tumor cells arranged in a solid, sarcoma-like pattern; dense neutrophil infiltrations can be seen inside and between tumor cells, and can be associated with neutrophilia; most tumors are peripheral, and in some cases, focal adenoid differentiation and mucinous production are present |
Typical representative:
CKs (CK7, CK20),
EMA, TTF-1 (+/–) and
napsin (in case of adenocarcinoma
differentiation), P40 and
high-molecular-weight CKs (in case of
squamous-cell carcinoma) Others: PCK, keratin, vimentin, CD45 and NSE(+), GFAP(–) |
|
| Carcinosarcoma |
NSCLCs:
adenocarcinoma or squamous-cell carcinoma |
Sarcoma:
specific fibrosarcoma or malignant fibrohistiocytoma, or similar to chondrosarcoma, osteosarcoma, rhabdomyosarcoma, or angiosarcoma |
Typical representative:
CKs (CK5/6, CK7),
EMA, TTF-1 and
napsin (in case of adenocarcinoma
differentiation), P40 and
high-molecular-weight CKs (in case of
squamous-cell carcinoma), Markers of sarcomatous
differentiation: rhabdomyosarcoma myogenic marker(+);
osteosarcoma S-100(+), high-grade fetal
adenocarcinoma sarcoma: β-catenin is
expressed on the cell
membrane Others: PCK, P63, CAM5.2(+) |
| Pulmonary blastoma | Pulmonary blastoma is a bipolar tumor consisting of primitive epithelium similar to that of well-differentiated fetal adenocarcinoma and primitive mesenchymal matrix containing high nucleo-plasma ratio blastocytoid cells |
Typical representative:
CKs, CK7, TTF-1, and
napsin expression in the
adenocarcinoma; vimentin in
blastematous stroma (myogenic markers in case of
rhabdomyosarcoma component) Others: SP-A; mulberry-like structure: GATA-6, Syn, NSE, CgA, CD10 and biotin(+); uncertainties: vimentin, desim, SMA, MSA, myoglobin, S-100(+) possibly; germinoma: AFP, PLAP(+), β-catenin is expressed on the nucleus |
|
NSCLC, non-small-cell lung cancer; PSC, pulmonary sarcomatoid carcinoma.