Sarcomatoid carcinoma of the lung pathophysiology
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]
Overview
The exact pathogenesis of [disease name] is not fully understood.
OR
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
OR
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
OR
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
OR
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
OR
The progression to [disease name] usually involves the [molecular pathway].
OR
The pathophysiology of [disease/malignancy] depends on the histological subtype.
Pathophysiology
Physiology
The normal physiology of [name of process] can be understood as follows:
Pathogenesis
- The pathogenesis of sarcomatoid carcinoma of the lung is characterized by a rare epithelial origin and morphologic features suggestive of a malignant mesenchymal tumor.[1][2]
- Four major hypotheses may explain sarcomatoid neoplasms:[3][4]
- The embryonic rest hypothesis: This theory suggests that sarcomatoid tumors are the result of misplaced “mini-organs” that has epithelial and stromal component.
- The collision hypothesis: This theory implies separate but concomitant malignant proliferation of epithelium and mesenchyme.
- The stromal induction/metaplasia hypothesis: This theory suggests that sarcomatous elements are an atypical response to the growth of a carcinoma.
- Totipotential hypothesis: This hypothesis proposes an origin from a single totipotential stem cell that differentiates into epithelial and mesenchymal components.
Genetics
- The development of sarcomatoid carcinoma is the result of multiple genetic mutations such as:[5]
- EGFR
- K-ras
Associated Conditions
Conditions associated with [disease name] include:
- [Condition 1]
- [Condition 2]
- [Condition 3]
Gross Pathology
- Sarcomatoid carcinomas can arise centrally or peripherally.[6][7]
- Most commonly present as poorly circumscribed solitary peripheral masses.
- Sarcomatoid carcinoma is commonly found in upper lobe of lungs.
- Tumors are large, ranging from 1 to 13 cm, with a median of 4.9 cm, and often invade the chest wall.
- Tumor consistency is described as soft and fleshy or firm, hard, or rubbery.
- Cut surfaces vary from white-grey to yellow, frequently show hemorrhagic and necrotic foci, and occasionally demonstrate cavitation.
Microscopic Pathology
On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
References
- ↑
- ↑ Franks TJ, Galvin JR (2010). "Sarcomatoid carcinoma of the lung: histologic criteria and common lesions in the differential diagnosis". Arch. Pathol. Lab. Med. 134 (1): 49–54. doi:10.1043/2008-0547-RAR.1. PMID 20073605.
- ↑ Thompson L, Chang B, Barsky SH (March 1996). "Monoclonal origins of malignant mixed tumors (carcinosarcomas). Evidence for a divergent histogenesis". Am. J. Surg. Pathol. 20 (3): 277–85. PMID 8772780.
- ↑ Franks TJ, Galvin JR (January 2010). "Sarcomatoid carcinoma of the lung: histologic criteria and common lesions in the differential diagnosis". Arch. Pathol. Lab. Med. 134 (1): 49–54. doi:10.1043/2008-0547-RAR.1. PMID 20073605.
- ↑ Billah, Shahreen; Stewart, John; Staerkel, Gregg; Chen, Su; Gong, Yun; Guo, Ming (2011). "EGFR and KRAS mutations in lung carcinoma". Cancer Cytopathology. 119 (2): 111–117. doi:10.1002/cncy.20151. ISSN 1934-662X.
- ↑ Rossi G, Cavazza A, Sturm N, Migaldi M, Facciolongo N, Longo L, Maiorana A, Brambilla E (March 2003). "Pulmonary carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements: a clinicopathologic and immunohistochemical study of 75 cases". Am. J. Surg. Pathol. 27 (3): 311–24. PMID 12604887.
- ↑ Koss MN, Hochholzer L, Frommelt RA (December 1999). "Carcinosarcomas of the lung: a clinicopathologic study of 66 patients". Am. J. Surg. Pathol. 23 (12): 1514–26. PMID 10584705.