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Open Access Case Report

Basaloid carcinoma of the lung associated with central cavitation: a unique surgical case focusing on cytological and immunohistochemical findings

Sohsuke Yamada1*, Hirotsugu Noguchi1, Atsunori Nabeshima1, Takashi Tasaki1, Shohei Kitada1, Tetsuro Baba2, Hidetaka Uramoto2, Takeshi Hanagiri2 and Yasuyuki Sasaguri1

Author Affiliations

1 Departments Of Pathology And Cell Biology, School Of Medicine, University Of Occupational And Environmental Health, Kitakyushu, Japan

2 Departments Of Surgery II, School Of Medicine, University Of Occupational And Environmental Health, Kitakyushu, Japan

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Diagnostic Pathology 2012, 7:175  doi:10.1186/1746-1596-7-175

Published: 11 December 2012

Abstract

A history of an increase in pulmonary mass was presented in the right upper lobe of a 72-year-old male. The bronchial brushing cytology specimens contained many sheet-like or three-dimensional clusters of malignant cells having small to medium-sized, uniform oval to round, and hyperchromatic nuclei, inconspicuous nucleoli, and scanty cytoplasm, admixed with mitotic figures. A coarsely granular chromatin pattern was predominantly noted. We first interpreted it as suspicious of malignancy, such as atypical carcinoid. A right upper lobectomy was performed, and gross examination revealed a centrally cavity-formed tumor lesion, containing asymmetrically thinned wall and looking grayish to whitish, partly adjacent to the bronchiolar wall. On microscopic examination, the tumor was predominantly composed of a solid proliferation of atypical epithelial cells without apparent glandular or squamous differentiation, often arranged in an alveolar growth pattern with peripheral palisading. Immunohistochemically, these atypical cells are negative for all three neuroendocrine markers and thyroid transcription factor 1, whereas positive for 34βE12, p63 and S-100 protein. Therefore, we finally made a diagnosis of basaloid carcinoma with cavity formation. We should be aware that, owing to its characteristic features, cytopathologists might be able to raise basaloid carcinoma of the lung as one of differential diagnoses, based on careful cytological examination.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.dianosticpathology.diagnomx.eu/vs/1519986488570234 webcite

Keywords:
Basaloid carcinoma; Lung; Cytology; Cavitation