1
|
Zhang MY, Tang LS, Qin ZJ, Hao YT, Cheng K, Zheng A. Clinical features and prognostic factors of pulmonary carcinosarcoma: A nomogram development and validation based on surveillance epidemiology and end results database. Front Med (Lausanne) 2022; 9:988830. [PMID: 36330063 PMCID: PMC9622765 DOI: 10.3389/fmed.2022.988830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/03/2022] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Pulmonary carcinosarcoma (PCS) is a rare but aggressive malignant disease in the lung. It is characterized by coexisting histologic elements of carcinomatous and sarcomatous components. This study aimed to comprehensively understand the clinical features of PCS and develop a nomogram for prognostic prediction of PCS patients. METHODS Data were collected from the Surveillance Epidemiology and End Results (SEER) database between 1975 and 2018. Propensity-score matching (PSM) was used to match the demographic characteristic of the PCS vs. pulmonary sarcoma (PS). Cancer-specific survival (CSS) and overall survival (OS) were the main endpoints of the survival of patients and were evaluated using the Kaplan Meier curves and Cox proportional hazards regression. We further randomly split enrolled PCS patients from SEER into the training and validation sets. All independent predictors for OS of the training set were integrated to create a predictive nomogram. The performance of the nomogram was determined by discrimination, calibration ability, clinical usefulness, and risk stratification ability both in the training and validation cohorts. In addition, the clinical data of PCS patients from the West China Hospital were also retrospectively analyzed by this model. RESULTS A total of 428 PCS patients and 249 PS patients were enrolled from SEER. Compared to pure PS, PCS was associated with significantly better survival in the unmatched cohorts, whereas non-significantly better survival after PSM. In subgroup analysis, PCS showed significantly worse survival than pure PS in subgroups among the race, marital status, and radiation treatment. A nomogram was constructed for PCS patients' survival prediction by combining the independent risk factors, including gender, stage, surgery, radiation, and chemotherapy. The nomogram showed good discrimination, calibration, and predictive power in the training and validation sets. Risk stratification analysis indicated that the nomogram scores efficiently divided PCS patients into low and high-risk groups. CONCLUSION PCS is a rare malignant disease of the lung with distinct clinical features. It had a comparable survival compared with pure PS in the matched cohorts. In addition, a nomogram was developed and validated for predicting the OS in PCS patients.
Collapse
Affiliation(s)
- Ming-Yi Zhang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lian-Sha Tang
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhao-Juan Qin
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ya-Ting Hao
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Ke Cheng
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ai Zheng
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
2
|
Mekheal E, Kapoor A, Roman S, Mekheal N, Millet C, Mekheal M, Maroules M. Pulmonary Carcinosarcoma: A Rare Disease With Challenging Diagnosis and Treatment. Cureus 2022; 14:e26901. [PMID: 35983399 PMCID: PMC9376117 DOI: 10.7759/cureus.26901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/05/2022] Open
Abstract
Pulmonary carcinosarcoma (PCS) is a rare type of non-small cell cancer. Overall, middle-aged and older smokers are the most affected age and sex groups. The diagnosis of PCS is difficult due to the absence of characteristic imaging findings. Additionally, preoperative biopsies do not usually reflect the heterologous nature of this tumor. Given the rarity of such tumors and the challenging diagnosis, the prognostic factors have not been established, and the overall prognosis remains poor. The valid therapeutic options are still limited. Here, we report a rare case of metastatic PCS that was accidentally discovered by imaging and properly diagnosed after surgical resection. The clinicopathological features, diagnostic tools, genetic theories, prognosis, and therapeutic options of this rare cancer are also discussed.
Collapse
|
3
|
Spagnoli L, Petrelli F, Fratini G, De Nisi MC, Camerini A, Giusti A, Perotti B, Cavazzana A, Arganini M, Ambrosio MR. A look towards the clonal origin of metastatic pulmonary carcinosarcoma: Report of a patient with an unexpected long-term survival. TUMORI JOURNAL 2022; 108:NP5-NP10. [PMID: 35168438 DOI: 10.1177/03008916221077142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Pulmonary carcinosarcoma is a rare histological subtype of non-small cell lung cancer, defined by the combination of epithelial and mesenchimal elements. Prognosis is usually dismal, with a median survival of about 6 months. The use of immunotherapy by blockade of PD1/PD-L1 immune checkpoint signaling has been shown to improve patients' survival. However, local aggressiveness and distant metastases are frequent. Spread to the gastrointestinal tract is seldom reported. The genetic landscape of the disease has only recently begun to emerge, pointing at TP53, KRAS, EGFR and MET as the most common mutated genes. CASE DESCRIPTION We describe the case of a metastatic patient with 37 months overall survival, treated by an aggressive multimodal approach combining surgery, chemotherapy, radiotherapy and immunotherapy. To shed new light on the molecular basis for sarcomatoid component in lung carcinoma, we performed next generation sequencing analysis of the squamous and sarcomatoid component by the two sites. We demonstrated a clonal origin and hypermutability of the sarcomatous elements that may account for the good response to immunotherapy. Moreover, we identified some mutations involving TP53 and EGFR genes, targetable by already available drugs. CONCLUSIONS We depicted a model of how a squamous cell carcinoma can differentiate during its natural history into sub-clonal populations with different features and may ultimately result in a neoplasm (i.e. pulmonary carcinosarcoma) showing clonal heterogeneity. Our data might contribute to a better understanding of the pathogenesis and molecular mechanisms of this rare tumor and open new ways for a more tailored approach.
Collapse
Affiliation(s)
| | | | - Geri Fratini
- Surgery Unit, Ospedale Unico Versilia, Azienda Toscana Nord Ovest, Pisa, Italy
| | | | - Andrea Camerini
- Oncology Unit, Ospedale Unico Versilia, Azienda Toscana Nord Ovest, Pisa, Italy
| | - Andrea Giusti
- Pathology Unit, Azienda Toscana Nord Ovest, Pisa, Italy
| | - Bruno Perotti
- Surgery Unit, Ospedale Unico Versilia, Azienda Toscana Nord Ovest, Pisa, Italy
| | | | - Marco Arganini
- Surgery Unit, Ospedale Unico Versilia, Azienda Toscana Nord Ovest, Pisa, Italy
| | | |
Collapse
|
4
|
Liu XW, Chen XR, Rong YM, Lyu N, Xu CW, Wang F, Sun WY, Fang SG, Yuan JP, Wang HJ, Wang WX, Huang WB, Xu JP, Yue ZY, Chen LK. MET exon 14 skipping mutation, amplification and overexpression in pulmonary sarcomatoid carcinoma: A multi-center study. Transl Oncol 2020; 13:100868. [PMID: 32920328 PMCID: PMC7492996 DOI: 10.1016/j.tranon.2020.100868] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/02/2020] [Accepted: 08/05/2020] [Indexed: 01/11/2023] Open
Abstract
High frequency of MNNG HOS transforming (MET) exon 14 skipping mutation (MET exon 14Δ) has been reported in pulmonary sarcomatoid carcinomas (PSCs). However, the frequencies differ greatly. Our study aims to investigate the frequency of MET alterations and the correlations among MET exon 14Δ, amplification, and protein overexpression in a large cohort of PSCs. MET exon 14Δ, amplification, and protein overexpression were detected in 124 surgically resected PSCs by using Sanger sequencing, fluorescent in situ hybridization (FISH), and immunohistochemistry (IHC) respectively. MET exon 14Δ was identified in 9 (7.3%) of 124 cases, including 6 pleomorphic carcinomas, 2 spindle cell carcinomas and 1 carcinosarcoma. MET amplification and protein overexpression were detected in 6 PSCs (4.8%) and 25 PSCs (20.2%), respectively. MET amplification was significantly associated with overexpression (P < 0.001). However, MET exon 14Δ has no correlation with MET amplification (P = 0.370) and overexpression (P = 0.080). Multivariable analysis demonstrated that pathologic stage (hazard ratio [HR], 2.78; 95% confidence interval [CI], 1.28–6.01; P = 0.010) and MET amplification (HR, 4.71; 95% CI, 1.31–16.98; P = 0.018) were independent prognostic factors for poor median overall survival (mOS). MET alterations including MET exon 14Δ and amplification should be recommended as routine clinical testing in PSCs patients who may benefit from MET inhibitors. MET IHC appears to be an efficient screen tool for MET amplification in PSCs.
Collapse
Affiliation(s)
- Xue-Wen Liu
- Department of Oncology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, PR China
| | - Xin-Ru Chen
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, PR China
| | - Yu-Ming Rong
- Department of VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, PR China
| | - Ning Lyu
- Department of Minimally Invasive Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, PR China
| | - Chun-Wei Xu
- Department of Pathology, Fujian Cancer Hospital, Fujian, PR China
| | - Fang Wang
- Department of Molecular Diagnostic, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, PR China
| | - Wen-Yong Sun
- Department of Pathology, Chinese Academy of Sciences University Cancer Hospital (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, PR China
| | - San-Gao Fang
- Department of Pathology, Daping Hospital and Research Institute of Surgery, the Third Military Medical University, Chongqing, PR China
| | - Jing-Ping Yuan
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, PR China
| | - Hui-Juan Wang
- Department of Respiratory Medicine, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Wen-Xian Wang
- Department of Chemotherapy, Chinese Academy of Sciences University Cancer Hospital (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, PR China
| | - Wen-Bin Huang
- Department of Pathology, Nanjing Hospital (Nanjing First Hospital), Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Jian-Ping Xu
- Department of Pathology, Anhui Chest Hospital, Hefei, Anhui, PR China
| | - Zhen-Ying Yue
- Dapartment of Pathology, the Central Hospital of Shengli Oilfield, Dongying, PR China
| | - Li-Kun Chen
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, PR China.
| |
Collapse
|
5
|
Devi P, Singh N, Tortora MJ. Pulmonary Carcinosarcoma: A Case Report of Biphasic Lung Tumor. Cureus 2019; 11:e5643. [PMID: 31700745 PMCID: PMC6822921 DOI: 10.7759/cureus.5643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Pulmonary carcinosarcoma is an unusual biphasic tumor of the lung with carcinomatous and sarcomatous components. We report a case in a 71-year-old female who presented with a 13-cm lung mass. Microscopic examination revealed squamous cell carcinoma and chondrosarcoma with focal spindle cell atypia. In the most recent version of the World Health Organization (WHO) classification, carcinosarcoma is included in the category of sarcomatous neoplasms with a poorer prognosis than non-small cell lung carcinoma.
Collapse
Affiliation(s)
- Pooja Devi
- Pathology, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Livingston, USA
| | - Natasha Singh
- Pathology, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Livingston, USA
| | - Mathew J Tortora
- Pathology, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Livingston, USA
| |
Collapse
|
6
|
King N, Kukreja K, Murzabdillaeva A, Ali Y, Willis J, Maiti A, Ma H, Bull J. A rare presentation of carcinosarcoma of the bone in a young female; response with gemcitabine and docetaxel. Clin Sarcoma Res 2019; 9:10. [PMID: 31304003 PMCID: PMC6604449 DOI: 10.1186/s13569-019-0120-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/25/2019] [Indexed: 11/17/2022] Open
Abstract
Background Sarcomatoid carcinoma, or carcinosarcoma, is a neoplasm that contains both sarcomatous and carcinomatous elements. It is an extremely rare cancer most often arising from visceral organs. Here we report the seventh documented de novo case of carcinosarcoma of the bone, in a young female who showed initial clinical improvement with gemcitabine and docetaxel. Case presentation A 36-year-old Caucasian female presented with diffuse musculoskeletal pain that had progressed from her shoulder to her back, arm, and knee over 6 months. Imaging revealed diffuse sclerotic lesions of bilateral humeral heads, iliac and ischial bones, and thoracic and lumbar spine. Histopathologic examination of biopsies from the T9 vertebra and left femur showed mainly sarcomatous spindle cells with focal osteoid production. Immunostaining showed the cells to be OSCAR cytokeratin, patchy positive for pankeratin, and negative for CK7, GATA3, S100, SOX10, CD99, EMA, AE1/AE3, and HMW keratin indicative of an epithelial origin. After thorough clinical correlation, sarcomatoid carcinoma of a visceral organ was excluded and the diagnosis of primary sarcomatoid carcinoma of the bone was ultimately favored. She received chemotherapy with gemcitabine and docetaxel, and showed improvement at 6 months but ultimately passed 1 year post diagnosis. Conclusions Primary carcinosarcoma of the bone is an extremely rare malignancy. Early diagnosis is crucial as localized disease may be curable with resection. As shown in this case, combination chemotherapy with gemcitabine and docetaxel is a potential option in patients with unresectable or metastatic disease.
Collapse
Affiliation(s)
- Nicholas King
- 1University of Texas Health Sciences Center at Houston, McGovern Medical School, Houston, TX USA
| | - Keshav Kukreja
- 1University of Texas Health Sciences Center at Houston, McGovern Medical School, Houston, TX USA
| | - Albina Murzabdillaeva
- 1University of Texas Health Sciences Center at Houston, McGovern Medical School, Houston, TX USA
| | - Yasir Ali
- 1University of Texas Health Sciences Center at Houston, McGovern Medical School, Houston, TX USA
| | - Jason Willis
- 2University of Texas Health Sciences Center MD Anderson Cancer Center, Houston, TX USA
| | - Abhishek Maiti
- 2University of Texas Health Sciences Center MD Anderson Cancer Center, Houston, TX USA
| | - Hilary Ma
- 2University of Texas Health Sciences Center MD Anderson Cancer Center, Houston, TX USA
| | - Joan Bull
- 1University of Texas Health Sciences Center at Houston, McGovern Medical School, Houston, TX USA
| |
Collapse
|
7
|
Imaging, Histopathologic, and Treatment Nuances of Pulmonary Carcinosarcoma. Case Rep Radiol 2017; 2017:8135957. [PMID: 29075544 PMCID: PMC5623769 DOI: 10.1155/2017/8135957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 08/16/2017] [Indexed: 11/17/2022] Open
Abstract
A 76-year-old female with coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus type II, and 40 pack-year smoking history presented with a four-day history of cough, productive of green-yellow sputum. Chest X-ray revealed opacification of the left upper lung field, and computed tomography (CT) of the chest showed a large cavitary lesion invading the T2-T3 vertebral bodies, extending into the epidural space, giving rise to mild cord compression. Biopsy of the lesion revealed a poorly differentiated neoplasm composed of distinct epithelial and mesenchymal components, consistent with carcinosarcoma. A metastatic workup was negative. Primary lung carcinosarcoma is a rare tumour that can demonstrate an especially aggressive clinical course; diagnosis is often nuanced by limited sampling at initial presentation, especially in a setting of advanced disease and debility that precludes consideration for upfront resection or more extensive, invasive sampling.
Collapse
|
8
|
Roesel C, Terjung S, Weinreich G, Hager T, Chalvatzoulis E, Metzenmacher M, Welter S. Sarcomatoid carcinoma of the lung: a rare histological subtype of non-small cell lung cancer with a poor prognosis even at earlier tumour stages. Interact Cardiovasc Thorac Surg 2017; 24:407-413. [PMID: 28025310 DOI: 10.1093/icvts/ivw392] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/27/2016] [Indexed: 12/18/2022] Open
Abstract
Objectives Pulmonary sarcomatoid carcinoma (PSC) is a rare histological subtype of non-small cell lung cancer and comprises a diagnostically and therapeutically challenging group of tumours. We explored the clinicopathological features and prognostic factors of this tumour. Methods We conducted a retrospective study of all patients who were treated for PSC in the Department of Thoracic Surgery between May 2005 and December 2014. Primary outcomes of interest were patient survival and prognostic factors. Results A total of 58 patients were treated for sarcomatoid carcinoma within the described period and 46 patients underwent surgical resection with curative intent. The mean follow-up period was 30 months. Of the operated patients, 21.7% had pathological stage I disease, and 78.3% had more advanced disease. There were 25 carcinosarcomas, 10 pleomorphic carcinomas, 7 spindle cell carcinomas, 3 giant cell carcinomas and 1 pulmonary blastoma. Overall 5-year survival of the operated patients was 28.7%. A total of 28 patients experienced recurrence and died cancer-related. Our analysis revealed that tumour size, gender, histological entity, lymphatic vessel invasion (L1) and vascular invasion (V1) did not influence survival. There was a trend for decreased survival in older patients (>65 years). Conclusions Surgical treatment can achieve satisfactory results with low perioperative mortality, but the overall prognosis even with multimodality concepts and in earlier tumour stages is worse compared to other types of non-small cell lung cancer.
Collapse
Affiliation(s)
- Christian Roesel
- Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Centre, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Sarah Terjung
- Department of Pneumology, Ruhrlandklinik, West German Lung Centre, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Gerhard Weinreich
- Department of Pneumology, Ruhrlandklinik, West German Lung Centre, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Thomas Hager
- Institute of Pathology, University Hospital, University of Duisburg-Essen, Essen Germany
| | - Eleftherios Chalvatzoulis
- Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Centre, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Martin Metzenmacher
- Department of Medical Oncology, West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Stefan Welter
- Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Centre, University Hospital, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
9
|
Shum E, Stuart M, Borczuk A, Wang F, Cheng H, Halmos B. Recent advances in the management of pulmonary sarcomatoid carcinoma. Expert Rev Respir Med 2016; 10:407-416. [DOI: 10.1586/17476348.2016.1157475] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
10
|
Uneven Distribution of Cancer Histology in the National Lung Screening Trial. Am J Med Sci 2015; 350:219-21. [PMID: 26148183 DOI: 10.1097/maj.0000000000000516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The National Lung Screening Trial reported a 20% lower mortality due to lung cancer in the patients screened with low-dose computed tomography (LDCT) compared with plain chest radiography (XRAY). A hypothesis was raised that LDCT should detect more cases of all tissue types or else the distribution of tissue types should be equal between groups. Data were extracted regarding the tissue types of lung cancer and presenting stages from the 2011 NSLT report. A total of 1,993 cases of tissue diagnosed lung cancer were reported, 1,054 for the LDCT group and 939 for the XRAY group. Two tissue types were more prevalent in the XRAY group: small cell carcinomas (16.9% versus 13%; P < 0.05) and other non-small cell (ONSC) carcinomas (16.8% versus 12.4%; P < 0.05). The ONSC category excluded the usual non-small cell tissue types: adenocarcinomas, squamous, and large cell carcinomas and did include other known biologically unfavorable tissue types. The XRAY group also had a disproportionately large number of stage IV small cell and ONSC tumors (P < 0.05 for ONSC). Bronchoalveolar cell carcinomas were more prevalent in the LDCT group (10.4% versus 3.7%, P < 0.05), likely reflecting greater sensitivity for detection. In summary, this review found uneven distribution of cases and higher preponderance of stage IV tumors for 2 adverse tissue types in the XRAY group. The results are consistent with greater severity of disease in the XRAY group with potential for length time bias and reduced mortality benefit from LDCT screening.
Collapse
|
11
|
Park SJ, Choo JY, Lee KY, Kim JH, Choi JW, Yeom SK, Kim BH. Usefulness of Digital Tomosynthesis for the Detection of Airway Obstruction: A Case Report of Bronchial Carcinosarcoma. Cancer Res Treat 2014; 47:544-8. [PMID: 25381829 PMCID: PMC4506098 DOI: 10.4143/crt.2013.220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 02/11/2014] [Indexed: 12/02/2022] Open
Abstract
Bronchial carcinosarcoma is a very rare malignant tumor that is composed of carcinomatous and sarcomatous elements. We describe the first case in which digital tomosynthesis was useful for the evaluation of airway obstruction by bronchial carcinosarcoma that was overlooked on initial chest radiography.
Collapse
Affiliation(s)
- Sung-Joon Park
- Departments of Radiology, Korea University Ansan Hospital, Korea University of College of Medicine, Ansan, Korea
| | - Ji Yung Choo
- Departments of Radiology, Korea University Ansan Hospital, Korea University of College of Medicine, Ansan, Korea
| | - Ki Yeol Lee
- Departments of Radiology, Korea University Ansan Hospital, Korea University of College of Medicine, Ansan, Korea
| | - Je-Hyeong Kim
- Departments of Pulmonology, Korea University Ansan Hospital, Korea University of College of Medicine, Ansan, Korea
| | - Jung-Woo Choi
- Departments of Pathology, Korea University Ansan Hospital, Korea University of College of Medicine, Ansan, Korea
| | - Suk Keu Yeom
- Departments of Radiology, Korea University Ansan Hospital, Korea University of College of Medicine, Ansan, Korea
| | - Baek Hyun Kim
- Departments of Radiology, Korea University Ansan Hospital, Korea University of College of Medicine, Ansan, Korea
| |
Collapse
|
12
|
Abstract
Pulmonary carcinosarcoma is a rare lung tumor, which contains both malignant carcinomatous and heterotopic sarcomatous components. There are only few case reports on the imaging diagnosis of this rare tumor. Herein, we present the radiological findings of this rare tumor, which was suspected on computed tomography (CT) scan due to atypical CT findings of malignant lung mass (not usually seen in bronchogenic carcinoma) and was finally confirmed histologically.
Collapse
Affiliation(s)
- Aditi Vohra
- Department of Radio-diagnosis, Gian Sagar Medical College and Hospital, Ram Nagar, Patiala, Punjab, India
| | - Harneet Narula
- Department of Radio-diagnosis, Gian Sagar Medical College and Hospital, Ram Nagar, Patiala, Punjab, India
| |
Collapse
|
13
|
|
14
|
Prediction of early response to chemotherapy in lung cancer by using diffusion-weighted MR imaging. ScientificWorldJournal 2014; 2014:135841. [PMID: 24688359 PMCID: PMC3943194 DOI: 10.1155/2014/135841] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 12/29/2013] [Indexed: 01/21/2023] Open
Abstract
Purpose. To determine whether change of apparent diffusion coefficient (ADC) value could predict early response to chemotherapy in lung cancer. Materials and Methods. Twenty-five patients with advanced non-small cell lung cancer underwent chest MR imaging including DWI before and at the end of the first cycle of chemotherapy. The tumor's mean ADC value and diameters on MR images were calculated and compared. The grouping reference was based on serial CT scans according to Response Evaluation Criteria in Solid Tumors. Logistic regression was applied to assess treatment response prediction ability of ADC value and diameters. Results. The change of ADC value in partial response group was higher than that in stable disease group (P = 0.004). ROC curve showed that ADC value could predict treatment response with 100% sensitivity, 64.71% specificity, 57.14% positive predictive value, 100% negative predictive value, and 82.7% accuracy. The area under the curve for combination of ADC value and longest diameter change was higher than any parameter alone (P ≤ 0.01). Conclusions. The change of ADC value may be a sensitive indicator to predict early response to chemotherapy in lung cancer. Prediction ability could be improved by combining the change of ADC value and longest diameter.
Collapse
|