Pleomorphic carcinoma of the lung: comparison of image features and pathologic findings

Objective: To retrospectively evaluate computed tomographic (CT) features of pleomorphic carcinoma of the lung and to compare these features with pathologic findings. Methods: Twenty-one patients (twenty men, eight women; mean age, 60.3±9.7 years; range, 41-79 years) with pleomorphic carcinoma were selected from our hospital.Two radiologists retrospectively reviewed CT features, which included size and location of tumor,attenuation values and lymph nodes in hilum and mediastinum, and invasion of pleura and chest wall. Results: On unenhanced CT scans, attenuation of the tumor was similar to that of the surrounding muscle. Invasion of pleura and chest wall was noted in sixteen patients. Tumors were located at the lung periphery in sixteen patients (16.2%). On contrast enhanced CT scans, lesions showed homogeneous or non-homogeneous enhancement. Low-attenuation areas on contrast-enhanced CT scans were found correspond to areas of myxoid degeneration, necrosis, or hemorrhage in pathologic specimens. Conclusion: Pleomorphic carcinomas of the lung often occurs in elderly males. The CT features of pleomorphic carcinomas include peripheral mass, frequent necrosis and pleural invasion. (authors)