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Pleomorphic carcinoma of lung: Comparison of CT features and pathologic findings

 Tae Hoon Kim  ;  Sang Jin Kim  ;  Kyu Ok Choe  ;  Sang Ho Cho  ;  Doo Yun Lee  ;  Hyung Joong Kim  ;  Jung-Gi Im  ;  Jin Mo Goo  ;  Hyun Ju Lee  ;  Young Hoon Ryu 
 RADIOLOGY, Vol.232(2) : 554-559, 2004 
Journal Title
Issue Date
Adult ; Aged ; Calcinosis/diagnostic imaging ; Calcinosis/pathology ; Carcinoma/diagnostic imaging* ; Carcinoma/pathology ; Diagnosis, Differential ; Female ; Humans ; Image Processing, Computer-Assisted* ; Lung/diagnostic imaging ; Lung/pathology ; Lung Neoplasms/diagnostic imaging* ; Lung Neoplasms/pathology ; Lymphatic Metastasis/diagnostic imaging ; Lymphatic Metastasis/pathology ; Male ; Middle Aged ; Neoplasm Invasiveness/diagnostic imaging ; Neoplasm Invasiveness/pathology ; Neoplasm Staging ; Observer Variation ; Pleura/diagnostic imaging ; Pleura/pathology ; Sensitivity and Specificity ; Thoracic Wall/diagnostic imaging ; Thoracic Wall/pathology ; Tomography, Spiral Computed*
PURPOSE: To retrospectively evaluate computed tomographic (CT) features of pleomorphic carcinoma of the lung and to compare these features with pathologic findings. MATERIALS AND METHODS: Ten patients (10 men, three women; mean age at diagnosis, 64.1 years; range, 43-75 years) with pleomorphic carcinoma treated from June 2000 to January 2003 were selected from two institutions. Two radiologists retrospectively reviewed CT features, which included size and location of tumor, presence of calcification, attenuation values and internal architecture of the mass, and invasion of pleura and chest wall. Attenuation values of the mass on CT scans were compared with pathologic findings in tumors in available gross specimens. Follow-up CT scans were not routinely obtained except in two patients with progressive pleural effusion and rapid growth of the tumor as seen on serial chest radiographs. RESULTS: On unenhanced CT scans, attenuation of the tumor was similar to that of the surrounding muscle. Calcification within the tumor was visible in one patient. Invasion of chest wall was noted in two patients. Seven patients had pleural invasion. Tumors were located at the lung periphery in nine patients. On contrast material-enhanced CT scans, lesions with the longest diameter larger than 5 cm showed central low-attenuation areas with substantial enhancement in the tumor periphery; in comparison, lesions with the longest diameter smaller than 5 cm showed homogeneous enhancement. Size of two lesions with the longest diameter larger than 5 cm increased rapidly after a follow-up of shorter than 3 weeks. Low-attenuation areas on contrast-enhanced CT scans were found to correspond to areas of myxoid degeneration, necrosis, or hemorrhage in pathologic specimens. CONCLUSION: Findings of this study suggest that pleomorphic carcinomas of the lung preferentially manifest as large peripheral lung neoplasms with a central low-attenuation area and frequently invade the pleura and chest wall.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Jin(김상진)
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Kim, Hyung Jung(김형중) ORCID logo https://orcid.org/0000-0003-2498-0683
Ryu, Young Hoon(유영훈) ORCID logo https://orcid.org/0000-0002-9000-5563
Lee, Doo Yun(이두연)
Cho, Sang Ho(조상호)
Choe, Kyu Ok(최규옥)
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