Sarcomatoid/metaplastic XXXX : a clinicopathological study of 12 cases.

@entity1 @entity0 @entity1418 @entity5 @entity1373 @entity189 @entity3909 @entity1492 @entity513 @entity421 @entity4383 @entity3 @entity81 @entity420
AIMS: To analyse the clinical and pathological features with long-term follow-up of a series of 12 cases of sarcomatoid @entity0 . methods and results: The cases were selected from the surgical files of the Department of Pathology, University of Edinburgh, between 1977 and 1988. The following clinical parameters were recorded: the age of the @entity1 , size of @entity5 , presence or absence of lymph node or distant metastases, and @entity1 survival. Pathological assessment included: the type of epithelial and mesenchymal components, the proportion of monophasic to biphasic @entity5 and the presence of adjacent in-situ @entity189 /atypical epithelial proliferation. The mean age of the @entity1 was 61 years with a median of 64 and range 46-82 years. The mean size of the @entity5 was 52 mm (range 22-100 mm). None of the @entity1 had distant @entity3 at presentation and only one case had local lymph node @entity3 which had a @entity3909 appearance. Five @entity1 were still alive after a minimum 12-year follow-up period. Four @entity1 died of their disease (three with lung @entity3 only and one with lung and bone metastases), one died of @entity189 and two @entity1 were lost to follow-up. Pathologically, four cases (33.3%) had no or almost undetectable epithelial structures by light microscopy, i.e. "monophasic @entity189 ". The remaining cases revealed varying proportions of both epithelial and mesenchymal elements, i.e. "biphasic @entity189 ". Of the epithelial component, six (50%) @entity5 had predominantly @entity189 of no special type, one lobular and one @entity420 . The mesenchymal component was @entity81 / @entity4383 -like, @entity1418 ( @entity1418 ), @entity421 -like and @entity1492 -like in five (42%), four (33%), two (17%) and one (8%) @entity5 , respectively. In 3/4 monophasic @entity5 , the mesenchymal component was of a low-grade @entity81 / @entity4383 type. In 6/12 (50%) of the cases there was associated in-situ atypical epithelial proliferation (five @entity513 in situ (DCIS) and one @entity1373 ). CONCLUSIONS: From this small series it appears that @entity189 is an uncommon @entity5 , which is large in size and tends to lack local or distant @entity3 at presentation. Pathologists should be alert to the presence of the bland monophasic @entity189 which has a pure mesenchymal appearance on light microscopy, but epithelial components demonstrated by cytokeratin immunohistochemistry. These showed metastases on long-term follow-up, similar to other histological patterns of @entity189 .
