2019 Volume 41 Issue 1 Pages 40-45
Background. Pulmonary carcinosarcoma is a rare primary lung malignancy, with an admixture of carcinomatous and sarcomatous components. When the carcinomatous element is fetal adenocarcinoma, we must distinguish carcinosarcoma from pulmonary blastoma. It is difficult to diagnose them from small biopsies. Case. A 71-year-old man presented, complaining of exertional dyspnea and left chest and back pain for 2 months. A chest X-ray revealed left pleural effusion. In pleural effusion, there were atypical cells with eccentric nuclei, consistent with adenocarcinoma. Thoracoscopy performed under local anesthesia showed many polypoid lesions of visceral and parietal pleura. Biopsy of the lesion revealed a biphasic structure with epithelial cells and mesenchymal spindle cells which was diagnosed as blastomatoid pulmonary carcinosarcoma. Conclusion. We reported a case of blastomatoid pulmonary carcinosarcoma diagnosed by thoracoscopy under local anesthesia.
