Imaging findings of pulmonary carcinosarcoma: A case report

Abstract

Pulmonary carcinosarcoma is a rare lung tumor, which contains both malignant carcinomatous and heterotopic sarcomatous components. There are only few case reports on the imaging diagnosis of this rare tumor. Herein, we present the radiological findings of this rare tumor, which was suspected on computed tomography (CT) scan due to atypical CT findings of malignant lung mass (not usually seen in bronchogenic carcinoma) and was finally confirmed histologically.

Keywords: Calcification; carcinosarcoma; computed tomography; lung.

Figure 1

Chest radiograph shows large mass in right lower zone silhouetting the dome, associated with multiple rounded radio-opacities in bilateral lung fields s/o lower zone malignant mass with pulmonary metastasis. Also noted is fibrocavitatory lesion in right apical region

Figure 2

Axial CT scan shows a large heterogeneous hypodense lobulated peripheral lung mass showing few calcific foci and few small areas of cavitation. Mass is invading the adjacent pleura

Figure 3

Lung window shows a large mass with lobulated margins, surrounding mild ground glass haze with small cavitating areas

Figure 4

Mass is highly invasive showing infiltration of right dome with direct transdiaphragmatic infiltration into the posterior segment of right lobe of liver

Figure 5

(a-b) Coronal and sagittal reformatted images show transdiaphragmatic invasion of mass into liver with few calcific foci. Multiple pulmonary metastatic lesions are seen with few calcific foci seen in larger ones. Also noted is an old cavity in right apical region- old tubercular infection

Figure 6

(a and b) Axial CT scan shows bulky hypodense deposits in right paraspinal region and right lower lobe with smaller ones in posterior subpleural region bilaterally. Note presence of small calcific foci within the larger metastatic lesions

Figure 7

H&E (hemotoxylin and eosin) stain of FNAC of primary lung tumor shows cluster of malignant squamous epithelial cells showing hyperchromatic, pleomorphic and irregular nuclei and bluish cytoplasm

Figure 8

Few tadpole cells are also seen