Wick M R, Ritter J H, Humphrey P A
Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St Louis, Missouri 63110, USA.
Am J Clin Pathol. 1997 Jul;108(1):40-53.
Sarcomatoid carcinomas (SC) of the lung are the most common pulmonary neoplasms that exhibit a composition by spindled or pleomorphic tumor cells. As such, many of them may be confused easily with true sarcomas diagnostically unless special immunohistological or ultrastructural analyses are performed. Reactivity is expected for keratin, epithelial membrane antigen, or collagen type IV in the sarcomalike elements in SC, although it may be focal. Electron microscopy often shows the presence of junctional complexes between tumor cells, with or without pericellular basal lamina and cytoplasmic skeins of intermediate filaments. Current terminological preferences are such that several formerly used terms--including "spindle-cell carcinoma," "pulmonary blastoma," "squamous cell carcinoma with pseudosarcomatous stroma," "pseudosarcoma," and "carcinosarcoma"--are now encompassed by the more generic designation of "sarcomatoid carcinoma." The clinical course of patients with this neoplasm is aggressive, with an overall 5-year survival rate approximating 20%.
肺肉瘤样癌（SC）是最常见的肺部肿瘤，由梭形或多形性肿瘤细胞组成。因此，除非进行特殊的免疫组织学或超微结构分析，否则其中许多在诊断上很容易与真正的肉瘤混淆。SC中肉瘤样成分对角蛋白、上皮膜抗原或IV型胶原预期有反应，尽管可能是局灶性的。电子显微镜检查常显示肿瘤细胞之间存在连接复合体，有或无细胞周围基膜和中间丝的胞质束。目前的术语偏好是，一些以前使用的术语——包括“梭形细胞癌”、“肺母细胞瘤”、“伴有假肉瘤性间质的鳞状细胞癌”、“假肉瘤”和“癌肉瘤”——现在都被更通用的“肉瘤样癌”这一名称所涵盖。患有这种肿瘤的患者临床病程具有侵袭性，总体5年生存率约为20%。
