The postoperative prognosis of primary pulmonary sarcomas. A review with a comparison between the histological forms and the other primary endothoracal sarcomas based on 474 cases.

On the basis of 41 personally observed cases from 1957 to 1974 and 435 case reports in the literature from 1957 to 1972, a scale of malignancy of the histological forms of primary pulmonary sarcomas is presented. A fairly continuous rise in the rate of malignancy according to the differentiation of the tissues can be convincingly recognized. The more mature a pulmonary sarcoma is, the better is the postoperative prognosis. The rate of malignancy increases from the relatively differentiated and tissue matured fibrosarcomas over the spindle cell sarcomas and round cell sarcomas, to the completely non-differentiated polymorph cell sarcomas. Primary myosarcomas, neurosarcomas and reticulum sarcomas of the lungs take an isolated position within this scale of malignancy. Primary lymphosarcomas are the most common and have clearly the best postoperative prognosis. The greatest malignancy is found with the carcinosarcomas. The characteristics of each of the histomorphological forms of primary sarcoma of the lungs are discussed. At the same time it is shown that the postoperative prognosis of endothoracal sarcomas is determined not only by their histological structure, but also by their localization in the lungs, mediastinum, or chest wall. Forty-one primary pulmonary sarcomas were compared with 22 sarcomas of the mediastinum and 17 sarcomas of the chest wall. Due to their long period of development, with rare symptoms and late diagnosis, sarcomas of the lungs and the mediastinum have a similar postoperative prognosis, in contrast to the endothoracal sarcomas of the chest wall which have a clearly more favourable prognosis.