摘要
目的：分析本院5年當中肺部多形細胞癌(pleomorphic carcinoma)（共10例）的臨床病理表現。 方法：從高雄榮民總醫院電腦病歷資料中收尋原發於肺部的多形細胞癌，時段是從1999至2003年。將病人的臨床表現與病理報告逐一分析。 結果：5年當中共有10個病人符合多形細胞癌的定義。其中7個是男性，3個女性。起始症狀跟一般肺癌類似，但腫瘤平均大小較大（7.5公分）且多位於週邊。5個病人組織學形態上完全是梭狀(spindle cell)及巨大(giant cell)細胞，另外5個病人的肺癌細胞是由類肉瘤細胞(sarcomatoid cell)加上其他非小細胞癌組成。目前3位病人還存活著且均有接受手術治療。死亡的7位病人平均存活時間是6個月。 結論：多形細胞癌處理上跟一般非小細胞癌相似，但是組織學形態卻類似肉瘤(sarcoma)。如果切片上沒有其它非小細胞癌區域，有時跟真正肉瘤很難區分，必須借助特殊染色。
並列摘要
Objective: To analyze the clinical and pathologic features of biopsy-proven pleomorphic carcinoma of the lung. Method: We retrospectively reviewed the data of patients with pleomorphic carcinoma of the lung, at a hospital in southern Taiwan. The computerized medical records database of Kaohsiung Veterans General Hospital (VGH-KS) was searched for patients who had pathological findings of pleomorphic carcinoma of the lung from 1999 through 2003. All of the medical records were reviewed, and a microscopic examination of the pathological specimens was performed once again. Results: Of the 10 patients with histologically confirmed pleomorphic carcinoma, 7 were men and 3 were women, and the median age was 69 years. Initial presenting symptoms were cough (n=10), fatigue (n=8), hemoptysis (n=5), chest wall pain (n=4), weight loss (n=4), dyspnea (n=4) and fever (n=1). The mean size of the tumors was 7.5 cm. The pathological specimens were obtained by transthoracic sono-guided biopsy, CT-guided biopsy or lobectomy during operation. Microscopically, the tumors of five patients were composed of spindle and giant cells exclusively, and the others had epithelial components with squamous cell carcinoma (n=3), adenocarcinoma (n=2) and large cell carcinoma (n=1). Six patients had immunohistochemical staining for their specimens. All of these specimens showed a positive result for cytokeratinstain. The average survival was 6 months. Conclusions: In our limited experience, the management of pleomorphic carcinoma is not different from that of other non-small cell lung carcinomas (NSCLC). But the histological findings are quite different. Sometimes pleomorphic carcinoma is regarded as sarcoma if there are no carcinomatous transition areas. The most common histological type among our cases was a tumor composed exclusively of spindle and giant cells.