title: Blastomatoid pulmonary carcinosarcoma: report of a case with a review of the literature.
abstract: BACKGROUND
  Pulmonary carcinosarcoma is a biphasic tumour with an unfavourable prognosis. The differential diagnosis includes pulmonary blastoma and is often challenging.
  
  
  METHODS
  We here describe a case of blastomatoid pulmonary carcinosarcoma in a 58-year-old patient, who underwent surgical resection. Histopathological examination revealed immature glandular epithelium resembling high-grade fetal adenocarcinoma expressing epithelial markers and membranous beta-catenin, and blastomatoid spindle cells with partial rhabdomyosarcoma-like differentiation. Both elements expressed p53, MDM2, and cyclin-dependent kinase 4 (CDK4), but not thyroid-transcription factor 1 (TTF-1). Mutation analysis of KRAS, EGFR, and beta-catenin revealed no mutations. Comparative genomic hybridization detected +1q, +6p, +6q24qter, +8q, +11q12q14, +11q23qter, +12q12q21, +12q24qter, +17q, +20q, -5q14q23, -9p13pter, -13q21q21, and amplifications at 12q14q21, 15q24qter, 20q11q12.
  
  
  CONCLUSIONS
  The observed molecular and cytogenetic findings may provide additional tools for the differential diagnosis of biphasic pulmonary neoplasms. Furthermore, TP53, MDM2, CDK4, and PTPN1 may be involved in tumourigenesis.
authors.affiliation: Department of Pathology, University Medical Center Göttingen, Robert-Koch-Straße 40, D-37075 Göttingen, Germany. schaeferinga@web.de
authors.forename: Inga-Marie
authors.initials: IM
authors.lastname: Schaefer
authors.forename: Carsten-Oliver
authors.initials: CO
authors.lastname: Sahlmann
authors.forename: Tobias
authors.initials: T
authors.lastname: Overbeck
authors.forename: Stefan
authors.initials: S
authors.lastname: Schweyer
authors.forename: Jan
authors.initials: J
authors.lastname: Menke
mesh_terms: D002296:Carcinosarcoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D002869:Chromosome Aberrations; D055028:Comparative Genomic Hybridization; D051358:Cyclin-Dependent Kinase 4 / Q000378:metabolism; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000378:metabolism / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D051736:Proto-Oncogene Proteins c-mdm2 / Q000378:metabolism; D018202:Pulmonary Blastoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D016159:Tumor Suppressor Protein p53; D051736:Proto-Oncogene Proteins c-mdm2; C495900:CDK4 protein, human; D051358:Cyclin-Dependent Kinase 4