Author of

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  P1.19 - Poster Session 1 - Imaging (ID 179)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10954

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    P1.19-008 - Clinicoradiological evaluation of surgically resected pulmonary pleomorphic carcinoma (ID 2742)

    09:30 - 09:30  |  Author(s): T. Iida
    • Abstract

    Background
    Pulmonary pleomorphic carcinoma is rare and aggressive subtype of non-small cell lung cancer, with a dual-cell component of spindle and/or giant cells, and of epithelial cells. The objective of this retrospective study was to assess the clinicoradiological characteristics and surgical outcome of this tumor.

    Methods
    Data were retrospectively examined for 25 patients who had undergone surgical resection for pulmonary pleomorphic carcinoma. Epithelial components of the pleomorphic carcinoma were as follows: 13 adenocarcinoma (52%), 3 squamous cell carcinoma (12%) and 2 large cell carcinoma (8%). 7 tumors (28%) were composed only of spindle and giant cells.

    Results
    21 patients (84%) were male. 19 patients (76%) were smokers. Of the 14 symptomatic patients (56%), 7 had cough, 5 had hemoptysis, 1 had back pain and 1 had fatigue. The size of the tumor ranged from 1.9 to 10.1cm (mean 5.2cm). The tumors were located peripherally in 21 patients (84%). Calcification within the tumor was visible in only one patient. The margin of the tumors was well defined in 24 patients (96%). Notch, spiculation and pleural indentation of the tumors were observed in 14, 8 and 6 patients respectively. The tumors were inhomogeneously enhanced in 20 patients (80%) on contrast-enhanced CT. Low attenuation areas on contrast-enhanced CT were found to correspond to areas of necrosis in pathologic specimens. Surrounding area of ground-glass attenuation was seen in 14 patients (56%). Among them, hemorrhagic foci were observed in the pathologic specimens in 5 patients. Invasion of chest wall, diaphragm, other lobes of the lung and SVC was noted in 7, 2, 2, 1 patients, respectively. In addition, 6 patients had pleural invasion. The median length of the follow-up examinations was 46 months (range, 2.3–153.5 months). The 5-year overall survival rate was 30%. Patients with tumors invading the parietal pleura, chest wall, diaphragm, and other lobes of the lung had significantly worse overall survival (P=0.027). The subtype of epithelial components did not affect prognosis. Figure 1

    Conclusion
    The CT features of pulmonary pleomorphic carcinoma were well-defined and lobulated tumor located peripherally with inhomogeneous enhancement. Peritumoral areas of ground-glass attenuation are associated with tumoral hemorrhage in some cases. Pleomorphic carcinoma carried a poor prognosis, even when completely resected. The lung cancer comprised of at least 10 % of spindle and/or giant cells is suggested to have an aggressive malignant behavior.