Table 1

The clinicopathologic and molecular genetic characteristics of pulmonary blastoma, pulmonary carcinosarcoma, and the present case
Diagnosis Age Sex Incidence Smoking Location Prognosis Morphology Immunohistochemical staining Cytgenetic aberrations Gene mutations
Epithelial elements Mesenchymal elements Epithelial elements Mesenchymal elements
Biphasic pulmonary blastoma [1,2,5-9] 35-52 M:F = 2:1 0.25-0.5% of pulmonary neoplasms Yes Upper lobe, central/endo-bronchial or peripheral Poor (5-year survival rate 16%) Low-grade adenocarcinoma of fetal lung type/well-differentiated fetal adenocarcinoma Undifferentiated blastema, striated or smooth muscle, cartilage, bone, yolk sac-like areas, melanocytic differentiation, morules EMA, pan-CK, CEA, TTF-1, CK7, nuclear/cytoplasmatic beta-catenin Vimentin, desmin, SMA, myoglobin, S-100; morules: synaptophysin, chromogranin A, CD10 Trisomies 2 and 8, allelic imbalances at 14q24q32 and 17p11p13 TP53, MDM2, beta-catenin (no EGFR or KRAS)
Carcinosarcoma [1,2,4,5] >50 M:F = 7:1 0.2-0.4% of pulmonary neoplasms Yes Upper lobe, central/endo-bronchial or peripheral Poor (5-year survival rate 20-50%) Squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma,large cell carcinoma Spindle cells, fibrosarcoma, rhabdomyosarcoma, chondrosarcoma, osteosarcoma, blastema-like stroma EMA, pan-CK, CK7, CAM5.2, CK5/6, p63, napsin, synaptophysin, chromogranin, CD56, membranous beta-catenin (TTF-1 negative) Desmin, myogenin, myoD1, S-100 Gains: 1q, 3q, 5p, 8q, 12p; Losses: 3q, 5q, 17p TP53 (no KRAS or beta-catenin)
Present case: blastomatoid variant of carcinosarcoma 58 M Yes Right upper lobe Alive, no relapse (22 months) High-grade adenocarcinoma of fetal lung type Spindle cells, rhabdomyosarcoma EMA, pan-CK, CK7, CEA, MDM2, CDK4, focal p63, membranous beta-catenin (TTF-1 negative) Vimentin, desmin, EGFR, CD56, myogenin, MDM2, CDK4 Gains: 1q, 6p, 6q24qter, 8q, 11q12q14, 11q23qter, 12q12q21, 12q24qter, 17q, 20q; Losses: 5q14q23, 9p13pter, 13q21q21; Amplifications: 12q14q21, 15q24qter, 20q11q12 TP53, MDM2, CDK4 (no EGFR, KRAS or beta-catenin)

EMA: epithelial membrane antigen.

CK: cytokeratin.

CEA: carcinoembryonic antigen.

TTF-1: thyroid transcription factor 1.

CDK4: cyclin-dependent kinase 4.

Schaefer et al.

Schaefer et al. BMC Cancer 2012 12:424   doi:10.1186/1471-2407-12-424

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