Spindle-cell lung carcinoma: classification of types, features of diagnosis and treatment

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Abstract

Spindle-cell lung carcinoma is a very rare disease, one of the forms of biphasic squamous-cell carcinoma, which can be detected in isolated cases. Despite different descriptions of this pathology, currently there is no consensus about methods of its exact morphological diagnosis and effective treatment. Therefore, it is very important to study all existing at the moment results of spindle-cell carcinoma research for the purpose of systematization and analysis of available data and development of effective methods of the disease control. The review contains modern understanding of clinical medicine about the tumor and different methods of its classification and identification based on worldwide scientific experience. The results of the research of spindle-cell lung carcinoma development causes are discussed, and statistical measures of its detection and used treatment methods are described. Spindle-cell lung carcinoma, frequently affecting male smokers as a large peripheral focus, has unfavourable prognosis even in those cases when the diagnosis was made at the early stage and radical surgery was performed. Distant metastases occur more frequently and earlier than in other tumors of the same group, and survival after recurrence is very low. One of the most promising methods of treatment in case of such malignancy is targeted immunotherapy such as anti-PD-1/PD-L1 antibodies aimed at inhibiting immune control point.

About the authors

Yu S Alferova

I.M. Sechenov First Moscow State Medical University

Email: AlferovaYuS@yandex.ru
Moscow, Russia

V D Surina

I.M. Sechenov First Moscow State Medical University

Email: AlferovaYuS@yandex.ru
Moscow, Russia

N V Karpov

I.M. Sechenov First Moscow State Medical University

Email: AlferovaYuS@yandex.ru
Moscow, Russia

References

  1. Bast R.C.Jr., Kufe D.W., Pollock R.E. et al. Cancer medicine. 5th ed. Hamilton: BC Decker. 2000; 2572 p.
  2. Liu H., Kho T.A., Kohane I.S., Sun Y. Predicting survival within the lung cancer histopathological hierarchy using a multi-scale genomic model of development. PLoS Med. 2006; 3 (7): 1090-102. doi: 10.1371/journal.pmed.0030232.
  3. Travis W.D., Colby T.V., Corrin B. et al. Histological typing of lung and pleural tumors. World Health Organization international histological classification of tumors. 3rd ed. Berlin: Springer. 1999; 574 p.
  4. Fishback N.F., Travis W.D., Moran C.A. et al. Pleomorphic (spindle/giant cell) carcinoma of the lung. A clinicopathologic correlation of 78 cases. Cancer. 1994; 73: 2936-2945. doi: 10.1002/1097-0142(19940615)73:12<2936::AID-CNCR2820731210>3.0.CO;2-U.
  5. Terada T. Spindle cell carcinoma of the lung: Frequency, clinical features, and immunohistochemical studies of three cases. Respiratory Med. CME. 2010; 3 (4): 241-245. doi: 10.1016/j.rmedc.2009.10.003.
  6. Chang Y.L., Lee Y.C., Shih J.Y., Wu C.T. Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma. Lung Cancer. 2001; 34 (1): 91-97. doi: 10.1016/S0169-5002(01)00224-0.
  7. Weerakkody Y. Primary sarcomatoid carcinoma of lung. Radiopaedia.org. 2012 Feb. 15. Online version: https://radiopaedia.org/articles/primary-sarcomatoid-carcinoma-of-lung.html (access date: 02.06.2017).
  8. Yuki T., Sakuma T., Ohbayashi C. et al. Pleomorphic carcinoma of the lung: a surgical outcome. J. Thorac. Cardiovasc. Surg. 2007; 134 (2): 399-404. doi: 10.1016/j.jtcvs.2007.04.018.
  9. Fujita T., Nishimura H., Kondo R. et al. Breast metastasis of pulmonary pleomorphic carcinoma: a case report. Surg. Case Rep. 2017; 3 (1): 25. doi: 10.1186/s40792-017-0302-6.
  10. Weissferdt A., Kalhor N., Canales R.J. et al. Spindle cell and pleomorphic («sarcomatoid») carcinomas of the lung: an immunohistochemical analysis of 86 cases. Hum. Pathol. 2017; 59: 1-9. doi: 10.1016/j.humpath.2016.08.003.
  11. Nakajima M., Kasai T., Hashimoto H. et al. Sarcomatoid carcinoma of the lung: A clinicopathologic study of 37 cases. Cancer. 1999; 86: 608-616. doi: 10.1002/(SICI)1097-0142(19990815)86:4<608::AID-CNCR9>3.0.CO;2-1.
  12. Kontic M., Stojsic J., Stevic R. et al. Could spindle cell lung carcinoma be considered and treated as sarcoma, according to its clinical course, morphology, immunophenotype and genetic finding? Pathol. Oncol. Res. 2013; 19 (1): 129-133. doi: 10.1007/s12253-012-9562-4.
  13. Tsuji T., Kim Y.H., Ozasa H. et al. Successful treatment with carboplatin and nanoparticle albumin-bound paclitaxel in a patient with pulmonary spindle cell carcinoma. Respir. Med. Case Report. 2015; 15: 48-50. doi: 10.1016/j.rmcr.2015.05.003.
  14. Addis B.J., Corrin B. Pulmonary blastoma, carcinosarcoma and spindle-cell carcinoma: An immunohistochemical study of keratin intermediate filaments. J. Pathol. 1985; 147: 291-301. doi: 10.1002/path.1711470407.
  15. Qi D.J., Liu B., Feng L. et al. Pulmonary spindle cell carcinoma with unusual morphology: A rare case report and review of the literature. Medicine (Baltimore). 2017; 96 (24): e7129. doi: 10.1097/MD.0000000000007129.
  16. Kida J.-I., Kanaji N., Kishi S. et al. An autopsy case of rapidly progressing spindle cell carcinoma of the lung accompanied with intratumor hemorrhage. Am. J. Case Rep. 2015; 16: 805-810. doi: 10.12659/AJCR.894443.
  17. Schrock B.A., Li D.S., Frampton M.G. et al. Pulmonary sarcomatoid carcinomas commonly harbor either potentially targetable genomic alterations or high tumor mutational burden as observed by comprehensive genomic profiling. J. Thorac. Oncol. 2017; 12: 932-942. doi: 10.1016/j.jtho.2017.03.005.
  18. Kim S., Kim M.Y., Koh J. et al. Programmed death-1 ligand 1 and 2 are highly expressed in pleomorphic carcinomas of the lung: comparison of sarcomatous and carcinomatous areas. Eur. J. Cancer. 2015; 51: 2698-2707. doi: 10.1016/j.ejca.2015.08.013.

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© 2017 Alferova Y.S., Surina V.D., Karpov N.V.

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