Malignant neepithelial lung tumors
In addition to the actual cancer( epithelial neoplasms), malignant non-epithelial tumors also form in the lungs. They originate from various tissues such as fatty, muscular, cartilaginous, fibrous, lymphoid, etc. However, they are extremely rare, according to statistics, about 2.4% of cases of primary lung cancer and are not considered separately.
What are malignant non-epithelial tumors?
Over the past two decades, a fairly large number of clinical observations have been accumulated, in which the histologically confirmed "primary malignant non-epithelial tumor" was reliably established. Analysis of foreign and domestic literature allowed finding data on 1500 patients with these tumors, of which primary sarcomas( about 500), lymphoid tissue tumors( more than 600) and, more rarely, carcinosarcoma, blastoma lungs, as well as malignant dysembryogenetic tumors of these organs. This makes it possible to give a differentiated characterization of the above listed variants of malignant non-epithelial lung formations, to present the features of the diagnosis, the clinic, the results of treatment, the factors of the prognosis.
Malignant non-epithelial lung tumor - sarcoma
Primary lung sarcoma is a malignant tumor of connective tissue nature. The source of sarcoma of the lung is often the connective tissue of the interalveolar septa, the walls of the bronchi. But due to the fact that connective tissue in the lungs is widely represented in different anatomical structures, which can be the source of the blastomatous process, this group of tumors is characterized by great heterogeneity. Neurosarcomas, fibrosarcomas, angiosarcomas, chondrosarcomas, liposarcas, rhabdomyosarcomas, cacinosarcomas, leiomyosarcomas, lymphosarcomas and some other types of tumors are described. This morphological diversity and gave reason to believe that as an independent nosological form of lung sarcoma is not found and is a collective term.
Concerning lung cancer, the frequency of primary organ sarcoma varies from 1 to 100 to 1 in 20 cases of lung cancer. In most cases, lung sarcoma looks like a massive tumor node that occupies part or all of the lung's lobe, in some cases affects the entire lung. Such a tumor is a delimited capsule from the surrounding pulmonary tissue, it can infiltrate and pulmonary parenchyma, gradually growing into large bronchi.
The main principle of treatment of patients with primary lung sarcoma is complex therapy - a combination of surgery, radiation and chemotherapy. The leading method of treatment of these patients is operative, which is explained by the lack of almost half of the patients metastases.
Depending on the location, as well as the stage of the lung sarcoma, surgical intervention consists of lobectomy( this is the removal of the lobe of the lung) or pneumonectomy( removal of the entire lung), and the long-term results of primary lung sarcoma are much better than lung cancer.
Malignant non-epithelial lung tumor - carcinosarcoma
Carcinosarcoma is an extremely rare lung tumor with a two-phase histological differentiation, which consists of malignant mesenchymal and epithelial components. The mesenchymal component is differentiated in the direction of the cartilage, bone or striated muscle. Affected mainly elderly men, especially smokers. In 75% of patients, the tumor is formed in the upper lobes of the lungs. It is rarely involved in the process of pleura. Based on the localization of this tumor, two clinical and morphological forms are distinguished. A solid parenchymal form is observed in about a third of carcinosarcoma carriers. Basically, this is a peripheral, often quite massive knot. He in the early stages of growth can have an asymptomatic character, but then, swelling in the pleura, mediastinum and chest wall, in the chest causes pain. The endobronchial or central form occupies 2/3 of the observations of carcinosarcoma. Its site often grows on a pedicle, differs by moderate or limited invasion of the lung tissue, and by the involvement of segmental and lobar bronchi in this process.
