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. 2012 Dec;46(6):576-82.
doi: 10.4132/KoreanJPathol.2012.46.6.576. Epub 2012 Dec 26.

Fine-needle aspiration cytology of pleomorphic carcinomas of the lung

Hee Seung Choi  1 , Hyesil Seol, Il Yeong Heo, Chang Won Jung, Soo Youn Cho, Sunhoo Park, Jae Soo Koh, Seung-Sook Lee
Affiliations

Fine-needle aspiration cytology of pleomorphic carcinomas of the lung

Hee Seung Choi et al. Korean J Pathol. 2012 Dec.

Abstract

Background: Pleomorphic carcinoma (PC) is a rare pulmonary malignancy. Because of its rarity and histological heterogeneity, cytopathologists might suspect PC only rarely on the basis of its cytological specimen. In addition, cytological findings from fine needle aspiration (FNA) specimens have rarely been described. Hence, we investigated the cytological features of FNA in the cases of PC.

Methods: We reviewed 7 FNA specimens of PC. The patients had undergone surgical resection at the Korea Cancer Center Hospital between 2007 and 2011. The cytological features of PC were assessed and compared with the histopathological features of the corresponding surgical specimen. Immunocytochemical analysis with cytokeratin and vimentin was performed on the cell blocks.

Results: The tumor cells were either dispersed or arranged in loose aggregates, and generally lacked any glandular or squamous differentiation. Pleomorphic or spindle shape tumor cells were observed, and mono-, bi-, or multi-nucleated giant cells were frequently observed. The background showed necrosis and contained numerous lymphocytes and neutrophils. Immunocytochemically, the tumor cells were positive for cytokeratin and vimentin.

Conclusions: PC displays characteristic cytological features. It might therefore be possible to make an accurate diagnosis of PC by assessing the degree of nuclear atypia.

Keywords: Cytology; Lung; Pleomorphic carcinoma.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Representative histologic (A, C, E) and cytologic (B, D, F) features of pleomorphic carcinoma. (A) Large cell carcinoma. The pleomorphic epithelioid cells form a solid sheet without glandular or squamous differentiation. (B) Large cell carcinoma. The cluster is composed of pleomorphic large cells with abundant thick cytoplasm. (C) Spindle cell component. The neoplastic spindle cells are arranged in interlacing fascicles. (D) Spindle cell component. The pleomorphic spindle cells are arranged in fascicles with hyperchromatic nuclei (inset). (E) Giant cell component. The tumor cells are pleomorphic and discohesive. (F) Giant cell component. Mono-, bi-, and multi-nucleated giant cells reveal bizarre and hyperchromatic nuclei and prominent nucleoli.
Fig. 2
Fig. 2
Numerous neutrophils are visible in the background.
Fig. 3
Fig. 3
Immunocytochemical stain results. (A) The epithelial cells show immunoreactivity to cytokeratin. (B) The vimentin is expressed mainly in the spindle cells and in some of the epithelioid cells.
See this image and copyright information in PMC

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