Batsakis J G, Suarez P
Division of Pathology and Laboratory Medicine, University of Texas M.D. Anderson Cancer Center, Houston, USA.
Adv Anat Pathol. 2000 Sep;7(5):282-93. doi: 10.1097/00125480-200007050-00002.
Sarcomatoid carcinoma of the upper aerodigestive tract continues to be one of the most difficult diagnostic challenges for surgical pathologists. Histogenesis has been settled in favor of a divergent (mesenchymal) differentiation of a carcinoma, most often a squamous cell carcinoma. Finding the carcinoma and/or its immunohistochemical marker in the metaplastic cells establishes the diagnosis. There are, however, lesions that can simulate sarcomatoid carcinomas to varying degrees, and in which neither a definable carcinoma nor immunohistochemical evidence of one can be found. Such lesions fall into several categories: 1. benign reactive lesions, 2. inflammatory myofibroblastic tumors, 3. sarcomas, usually low-grade, 4. atypical pseudosarcomatous proliferation. The clinicopathologic considerations of sarcomatoid carcinomas are presented in this context and include immunohistochemical findings, prognostic factors, and biologic course.
上呼吸消化道肉瘤样癌仍然是外科病理学家面临的最具诊断挑战性的疾病之一。组织发生学已倾向于癌的异向（间充质）分化，最常见的是鳞状细胞癌。在化生细胞中发现癌和/或其免疫组化标志物即可确立诊断。然而，有些病变可不同程度地模拟肉瘤样癌，且在这些病变中既找不到明确的癌，也找不到癌的免疫组化证据。这类病变可分为几类：1. 良性反应性病变；2. 炎性肌成纤维细胞瘤；3. 肉瘤，通常为低级别；4. 非典型假肉瘤样增生。本文在此背景下介绍了肉瘤样癌的临床病理考量，包括免疫组化结果、预后因素和生物学过程。
