Abstract：Objective: To investigate the value of radiography in the diagnosis of pulmonary sarcomatoid carcinoma(PSC) correlated with the clinical and pathological findings. Methods: Eight patients with PSC proven by surgery and pathology, underwent radiographic examination(X-ray and CT). The images were reviewed retrospectively and correlated with pathological manifestation. Results: In 8 cases, 6 cases had single mass(4 in right lung, 2 in left lung), and 2 had more than one mass. Seven patients underwent CT examination. The pre-contrast CT films of 5 cases exhibited large globular masses, and 3 showed irregular node. After administration of contrast medium, most of them had a heterogeneous enhancement. The CT films also showed other features: cavity in 1(with fungus), spiculation sign in 1, enlargement of lymph node of the hilum and mediastinum in 3, pleural fluid in 2, pleural nodes in 3, pulmonary atelectasis in 1, obstructive pneumonia in 2, metastasis out of the lung in 2, metastasis of the lung in 2 and rib destruction in 1. Microscopically, 1 was spindle cell carcinoma, other 7 cases were composed of spindle cell and epithelial cell. Immunohistochemically, CK was positive(++~+++) in 7 cases, and Vimentin(++~+++) in 6 cases, CEA(+++) in 1 case. Conclusion: Although PSC has no specific clinical features, it had both lung cancer and sarcomatoid features in most of the radiological signs. Finally, it is dependent on pathologic examination to establish the diagnosis.
2009, Vol. 20 
