Combined small cell lung carcinoma and giant cell carcinoma: a case report
Abstract Background Combined small cell lung carcinoma (SCLC) is defined as SCLC combined with elements of non-small cell lung carcinoma (NSCLC), accounting for approximately 30% of cases of SCLC. However, combined SCLC and giant cell carcinoma (GC) is very rare. Case presentation A 50-year-old woma...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-03-01
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| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40792-017-0328-9 |
| _version_ | 1819116437544894464 |
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| author | Tomohito Saito Koji Tsuta Kento J. Fukumoto Hiroshi Matsui Toshifumi Konobu Yoshitaro Torii Takashi Yokoi Takayasu Kurata Hiroaki Kurokawa Yoshiko Uemura Yukihito Saito Tomohiro Murakawa |
| author_facet | Tomohito Saito Koji Tsuta Kento J. Fukumoto Hiroshi Matsui Toshifumi Konobu Yoshitaro Torii Takashi Yokoi Takayasu Kurata Hiroaki Kurokawa Yoshiko Uemura Yukihito Saito Tomohiro Murakawa |
| author_sort | Tomohito Saito |
| collection | DOAJ |
| description | Abstract Background Combined small cell lung carcinoma (SCLC) is defined as SCLC combined with elements of non-small cell lung carcinoma (NSCLC), accounting for approximately 30% of cases of SCLC. However, combined SCLC and giant cell carcinoma (GC) is very rare. Case presentation A 50-year-old woman with a 45 pack-year smoking history was referred to our hospital for further investigation of an abnormal left hilar shadow. Chest computed tomography (CT) revealed a 28-mm solid pulmonary nodule in the left lower lobe and an enlarged left hilar lymph node adjacent to the left main pulmonary artery. CT-guided biopsy of the pulmonary nodule led to the diagnosis of high-grade neuroendocrine carcinoma. The preoperative clinical stage was defined as cT1bN1M0. Thus, the patient underwent left lower lobectomy with ND2a-2 lymph node dissection via thoracotomy. Pathological investigation revealed a 22-mm tumor and dense sheet-like growth of small tumor cells with scant cytoplasm and finely granular nuclear chromatin. Moreover, there was a sheet-like growth of bizarre, highly pleomorphic mono- or occasionally multinucleated giant cells, accounting for approximately 40% of the tumor. Both the small and giant cell components were thyroid transcription factor-1-positive and p40-negative and exhibited neuroendocrine differentiation, as indicated by positivity for synaptophysin and CD56 and negativity for chromogranin A. While the small cell component was E-cadherin-positive and vimentin-negative, the giant cell component was E-cadherin-negative and vimentin-positive, indicating an epithelial-to-mesenchymal transition. Only the small cell component was found within the mediastinal and hilar lymph nodes. The final pathological diagnosis was combined SCLC and GC, pT1bN2M0, and pStage IIIA. The patient received adjuvant chemotherapy with 4 cycles of cisplatin and irinotecan. No sign of recurrence has been noted for 1 year after the surgery. Conclusions This is the first detailed report of a unique case with combined SCLC and GC. The coexistence of SCLC and GC in the presented case might indicate several possibilities: (1) GC may arise from SCLC via epithelial-to-mesenchymal transition, (2) SCLC may arise from GC through phenotypic conversion, and (3) SCLC and GC may have derived from a common neuroendocrine origin. Further investigation is necessary to reveal the underlying pathological process. |
| first_indexed | 2024-12-22T05:17:05Z |
| format | Article |
| id | doaj.art-cb4b0f0f48c94bfa98122c83739490e0 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-22T05:17:05Z |
| publishDate | 2017-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-cb4b0f0f48c94bfa98122c83739490e02022-12-21T18:37:49ZengSpringerOpenSurgical Case Reports2198-77932017-03-01311410.1186/s40792-017-0328-9Combined small cell lung carcinoma and giant cell carcinoma: a case reportTomohito Saito0Koji Tsuta1Kento J. Fukumoto2Hiroshi Matsui3Toshifumi Konobu4Yoshitaro Torii5Takashi Yokoi6Takayasu Kurata7Hiroaki Kurokawa8Yoshiko Uemura9Yukihito Saito10Tomohiro Murakawa11Department of Thoracic Surgery, Kansai Medical University HospitalDepartment of Pathology, Kansai Medical University HospitalDepartment of Thoracic Surgery, Kansai Medical University HospitalDepartment of Thoracic Surgery, Kansai Medical University HospitalDepartment of Thoracic Surgery, Kansai Medical University HospitalDepartment of Thoracic Oncology, Kansai Medical University HospitalDepartment of Thoracic Oncology, Kansai Medical University HospitalDepartment of Thoracic Oncology, Kansai Medical University HospitalDepartment of Radiology, Kansai Medical University HospitalDepartment of Pathology, Kansai Medical University HospitalDepartment of Thoracic Surgery, Kansai Medical University HospitalDepartment of Thoracic Surgery, Kansai Medical University HospitalAbstract Background Combined small cell lung carcinoma (SCLC) is defined as SCLC combined with elements of non-small cell lung carcinoma (NSCLC), accounting for approximately 30% of cases of SCLC. However, combined SCLC and giant cell carcinoma (GC) is very rare. Case presentation A 50-year-old woman with a 45 pack-year smoking history was referred to our hospital for further investigation of an abnormal left hilar shadow. Chest computed tomography (CT) revealed a 28-mm solid pulmonary nodule in the left lower lobe and an enlarged left hilar lymph node adjacent to the left main pulmonary artery. CT-guided biopsy of the pulmonary nodule led to the diagnosis of high-grade neuroendocrine carcinoma. The preoperative clinical stage was defined as cT1bN1M0. Thus, the patient underwent left lower lobectomy with ND2a-2 lymph node dissection via thoracotomy. Pathological investigation revealed a 22-mm tumor and dense sheet-like growth of small tumor cells with scant cytoplasm and finely granular nuclear chromatin. Moreover, there was a sheet-like growth of bizarre, highly pleomorphic mono- or occasionally multinucleated giant cells, accounting for approximately 40% of the tumor. Both the small and giant cell components were thyroid transcription factor-1-positive and p40-negative and exhibited neuroendocrine differentiation, as indicated by positivity for synaptophysin and CD56 and negativity for chromogranin A. While the small cell component was E-cadherin-positive and vimentin-negative, the giant cell component was E-cadherin-negative and vimentin-positive, indicating an epithelial-to-mesenchymal transition. Only the small cell component was found within the mediastinal and hilar lymph nodes. The final pathological diagnosis was combined SCLC and GC, pT1bN2M0, and pStage IIIA. The patient received adjuvant chemotherapy with 4 cycles of cisplatin and irinotecan. No sign of recurrence has been noted for 1 year after the surgery. Conclusions This is the first detailed report of a unique case with combined SCLC and GC. The coexistence of SCLC and GC in the presented case might indicate several possibilities: (1) GC may arise from SCLC via epithelial-to-mesenchymal transition, (2) SCLC may arise from GC through phenotypic conversion, and (3) SCLC and GC may have derived from a common neuroendocrine origin. Further investigation is necessary to reveal the underlying pathological process.http://link.springer.com/article/10.1186/s40792-017-0328-9Combined small cell carcinomaGiant cell carcinomaEpithelial-to-mesenchymal transition |
| spellingShingle | Tomohito Saito Koji Tsuta Kento J. Fukumoto Hiroshi Matsui Toshifumi Konobu Yoshitaro Torii Takashi Yokoi Takayasu Kurata Hiroaki Kurokawa Yoshiko Uemura Yukihito Saito Tomohiro Murakawa Combined small cell lung carcinoma and giant cell carcinoma: a case report Surgical Case Reports Combined small cell carcinoma Giant cell carcinoma Epithelial-to-mesenchymal transition |
| title | Combined small cell lung carcinoma and giant cell carcinoma: a case report |
| title_full | Combined small cell lung carcinoma and giant cell carcinoma: a case report |
| title_fullStr | Combined small cell lung carcinoma and giant cell carcinoma: a case report |
| title_full_unstemmed | Combined small cell lung carcinoma and giant cell carcinoma: a case report |
| title_short | Combined small cell lung carcinoma and giant cell carcinoma: a case report |
| title_sort | combined small cell lung carcinoma and giant cell carcinoma a case report |
| topic | Combined small cell carcinoma Giant cell carcinoma Epithelial-to-mesenchymal transition |
| url | http://link.springer.com/article/10.1186/s40792-017-0328-9 |
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