Finley J L, Silverman J F, Dabbs D J
Department of Clinical Pathology and Diagnostic Medicine, East Carolina University School of Medicine, Greenville, NC 27834.
Diagn Cytopathol. 1988;4(3):239-43. doi: 10.1002/dc.2840040312.
The cytologic, immunocytochemical, and ultrastructural features of a pulmonary carcinosarcoma diagnosed by fine-needle aspiration biopsy are presented. Both malignant epithelial groups and bizarre spindle-shaped cells arranged in loose groups, microtissue fragments and in a dissociate fashion showed dual immunoperoxidase staining with cytokeratins and vimentin. Although the immunocytochemical staining pattern is typical of this neoplasm, it does not allow differentiation in all cases from the more common primary large-cell undifferentiated carcinoma, which can also show dual staining for cytokeratin and vimentin. However, the presence of poorly differentiated epithelial groupings associated with a malignant mesenchymal component set in a myxoid stroma should suggest the correct diagnosis. Cytologically, differentiating carcinosarcoma, a poorly differentiated malignancy showing dual staining for cytokeratin and vimentin, from a large-cell carcinoma is important, since the former may pursue a more indolent clinical course.
本文介绍了通过细针穿刺活检诊断的肺肉瘤样癌的细胞学、免疫细胞化学和超微结构特征。恶性上皮细胞群以及排列松散的奇异梭形细胞、微组织碎片和离散形式的细胞均显示细胞角蛋白和波形蛋白的双重免疫过氧化物酶染色。尽管免疫细胞化学染色模式是这种肿瘤的典型特征，但在所有情况下都无法与更常见的原发性大细胞未分化癌区分开来，后者也可显示细胞角蛋白和波形蛋白的双重染色。然而，存在与黏液样基质中的恶性间叶成分相关的低分化上皮细胞团应提示正确的诊断。在细胞学上，将显示细胞角蛋白和波形蛋白双重染色的低分化恶性肿瘤肉瘤样癌与大细胞癌区分开来很重要，因为前者的临床病程可能更为惰性。
