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Table 1 The clinicopathologic and molecular genetic characteristics of pulmonary blastoma, pulmonary carcinosarcoma, and the present case

From: Blastomatoid pulmonary carcinosarcoma: report of a case with a review of the literature

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, 59] 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)
  1. EMA: epithelial membrane antigen.
  2. CK: cytokeratin.
  3. CEA: carcinoembryonic antigen.
  4. TTF-1: thyroid transcription factor 1.
  5. CDK4: cyclin-dependent kinase 4.