A Case of Pulmonary Pleomorphic Carcinoma That Could Hardly Be Distinguished from a Malignant Pleural Mesothelioma

Abstract

Background. Pleomorphic carcinoma is defined as either a non-small cell lung carcinoma combined with neoplastic spindle and/or giant cells or a carcinoma that consists of only spindle and giant cells. At least 10% of the carcinoma should comprise spindle and/or giant cells for it to be classified as a pleomorphic carcinoma. Since it rarely occurs, few case reports have been reported. Case. A 72-year-old male visited our hospital due to exertional dyspnea. A chest X-ray and computed tomography revealed right pleural effusion and multiple pleural nodules. Based on thoracoscopic pleural biopsy, a history of asbestos exposure and his clinical course, we diagnosed malignant pleural mesothelioma. Thereafter the tumor increased expansively and he died. Autopsy confirmed a pleomorphic carcinoma of lung. Conclusions. Generally the diagnosis of pleomorphic carcinoma of lung is rarely established since it requires large tissue specimens by surgical resection and it is often diagnosed as other pulmonary tumors. The frequency of pleomorphic carcinoma of lung is rare and its clinical course is heterogeneous. Further accumulation of the number of cases is necessary.