Histochemical and ultrastructural features of an unusual pulmonary carcinosarcoma

Our plain-English summary of Histochemical and ultrastructural features of an unusual pulmonary carcinosarcoma, by K.G. Zimmerman, R.E. Sobonya, C.M. Payne (Human Pathology, 1981).

The study

• Authors: K.G. Zimmerman, R.E. Sobonya, C.M. Payne
• Journal: Human Pathology
• Published: 1981;12(11):1046-51
• Type of article: Case report
• Cited by: 28 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

An autopsy case is presented in which a pulmonary carcinosarcoma filled the left chest of a 61 year old man. The extensive pleural involvement that this neoplasm exhibited has not been reported previously. By light microscopy the neoplasm initially was considered a mesothelioma because of the pattern of glands and undifferentiated sarcomatous stroma. However, by electron microscopy the sarcomatous component was found to show rhabdomyoblastic differentiation. Neither histochemical stains nor electron microscopy supported a mesothelial origin for the glandular component. Differential diagnostic considerations of pleuropulmonary neoplasms showing rhabdomyosarcomatous differentiation are discussed. This case illustrates the importance of detailed study in order to characterize and properly classify these neoplasms.

In plain English

This article was a case report of one patient, a 61-year-old man who died with a tumor filling the left side of his chest. He had a 50 pack-year smoking history and had worked as an electrician for 35 years, but he denied any direct asbestos exposure. A biopsy taken during chest surgery was interpreted as a biphasic mesothelioma, and he was treated with chemotherapy. At autopsy the left lung could not be separated from the tumor surrounding it, and the combined mass of lung and tumor weighed 6 kilograms. The tumor had spread extensively along the pleura. No tumor was found outside the left chest. Special stains showed that the gland-forming tumor cells made an epithelial mucin, not the material typical of mesothelioma. Electron microscopy did not show the long, sinuous microvilli typical of mesothelioma. Electron microscopy also showed that the other, sarcomatous part of the tumor had skeletal muscle (rhabdomyoblastic) features. The authors concluded that the tumor was an unusual pulmonary carcinosarcoma, not a mesothelioma, and that the case showed the importance of detailed study to classify such tumors properly.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (autopsy case) with histochemical and electron microscopic study
• Who was studied: one 61-year-old man, studied at autopsy (authors at Arizona Health Sciences Center, Tucson, Arizona)
• Exposure: electrician for 35 years who denied any direct asbestos exposure; 50 pack-year smoking history
• Main results:
  • A biopsy taken at thoracotomy was interpreted as a biphasic mesothelioma
  • At autopsy, the left lung could not be dissected free from the tumor enveloping it; the entire mass of lung and tumor together weighed 6 kilograms
  • Histochemical stains of the glandular component indicated an epithelial mucin, which the authors said supports an origin from bronchial epithelium
  • Under electron microscopy, the microvilli of the epithelial cells were not long and sinuous
  • Under electron microscopy, cells of the sarcomatous component showed skeletal muscle features, including rudimentary myofibrils with Z bands
  • The authors stated that the histochemical and ultrastructural studies ruled out a diagnosis of mesothelioma
  • The authors presumed the tumor began in a small area of lung tissue around a small bronchus in the left lower lobe
• The authors' conclusion: The authors classified the tumor as an unusual pulmonary carcinosarcoma rather than a mesothelioma, and concluded that the case illustrates the importance of detailed study to characterize and properly classify such tumors

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Autopsy, Neoplasm, Mesothelioma.

Related studies

• 'Pleural' and pulmonary carcinosarcomas — F.G. Mayall, A.R. Gibbs (1992)
• Carcinosarcoma of the spermatic cord — M. Nistal, F. Burgos, et al. (1990)
• Sarcomatoid carcinoma (carcinosarcoma) of the lung mimics malignant pleural mesothelioma on 18F-FDG PET/CT: a report of 2 cases — A. Ciarallo, W. Makis, et al. (2012)
• Malignant epithelioid pleural mesothelioma versus peripheral pulmonary adenocarcinoma: a histochemical, ultrastructural, and immunohistologic study of 103 cases — M.R. Wick, T. Loy, et al. (1990)
• Benign papillary mesothelioma of peritoneum: a histological, histochemical and ultrastructural study of six cases — J.R. Goepel (1981)
• Ultrastructural features of diffuse malignant mesotheliomas — T.D. Oury, S.P. Hammar, et al. (1998)

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