J Lung Cancer.  2011 Jun;10(1):44-48. 10.6058/jlc.2011.10.1.44.

Pulmonary Carcinoma with beta-Human Chorionic Gonadotropin Expression: Further Understanding and Suggestions for This Entity from Six Cases Experience in a Single Institution

• Lee S
• Jeong JY
• Han J
• Sung CO
• Choi YS

• KMID: 2199894
• DOI: http://doi.org/10.6058/jlc.2011.10.1.44

Abstract

PURPOSE
beta-human chorionic gonadotropin (beta-hCG) expressing pulmonary carcinoma is very rare, and little is known about this entity. The aim of this study was to find the characteristic clinicopathologic features of beta-hCG expressing pulmonary carcinoma.
MATERIALS AND METHODS
Of all 2790 lobectomy specimens of lung excised between January 2006 and December 2010, only six cases of beta-hCG expressing pulmonary carcinoma were identified retrospectively. The cases were classified according to the WHO classification, and clinicopathologic features were investigated.
RESULTS
The patients consisted of 4 males and 2 females, and the median age was 64 years. Half of the patients presented with blood tinged sputum or hemoptysis. The median tumor diameter was 4.2 cm. All but one case showed prominent area of hemorrhage and necrosis. All six cases were pleomorphic carcinoma, composed of various types of non-small cell carcinomatous component and giant cell component. All cases showed significant area of beta-hCG positivity, and beta-hCG was usually expressed in the pleomorphic giant cells.
CONCLUSION
In pulmonary carcinoma with pleomorphic giant cells, is necessary to check immunohistochemical stain for beta-hCG and to follow up the serum beta-hCG levels, to further establish the concept of beta-hCG expressing pulmonary carcinoma.

Keyword

Pleomorphic carcinoma; Lung; Human chorionic gonadotropin

MeSH Terms

Chorion
Chorionic Gonadotropin
Female
Follow-Up Studies
Giant Cells
Hemoptysis
Hemorrhage
Humans
Lung
Male
Necrosis
Retrospective Studies
Sputum
Tolnaftate
Chorionic Gonadotropin
Tolnaftate

Figure

• 

  Fig. 1. Representative pathologic features of β-hCG expressing pulmonary carcinoma. (A) Gross photography shows a large necrotic mass. (B) Scanning view reveals extensive hemorrhage (hematoxylin-eosin stain, ×1). (C) The tumor was composed of poorly differentiated large tumor cells with pleomorphic giant cells (hematoxylin-eosin stain, ×200). The tumor cells are negative for p63 (inset) (ABC method, ×100). (D) The giant cell component shows marked pleomorphism with occasional multinucleation, which are similar morphology to syncytiotrophoblast (hematoxylin-eosin stain, ×400). (E) Immunohistochemical stains for β-hCG shows intense cytoplasmic positive in pleomorphic giant cells (ABC method, ×400).

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