To explore the diagnostic characteristics of primary sarcomatoid carcinoma of the pleura.

The clinical data of a case of primary sarcomatoid carcinoma of the pleura in the Department of Respiratory and Critical Care Medicine in Affiliated Hospital of Jining Medical University on June 24, 2018 was retrospectively analyzed. The 6 cases reports of primary sarcomatoid carcinoma of the pleura in CNKI, Wanfang Data, Pubmed and Google Scholar from 2010 to 2019 were searched, and the literatures were reviewed. The clinical, imaging, endoscopic and pathological diagnostic characteristics were summarized.

Data of 7 patients were collected, including 3 females and 4 males, who were 47-49 years old, presenting with dyspnea and chest pain. Chest CT showed thickened pleura and soft tissue mass, with fluid density shadow in the pleural cavity. CT enhanced scan showed mild or moderate enhanced mass. Positron emission tomography (PET)-CT showed the standardized uptake value of lesions was significantly increased. Thoracoscope showed multiple nodal and nubbly neoplasm on the parietal pleura. Spindle heterogenous cells were shown under pathologic microscopy. HE staining combined with immunohistochemistry was consistent with sarcomatoid carcinoma.

The clinical manifestations of primary sarcomatoid carcinoma of the pleura are nonspecific. Imaging shows irregular mass on the pleura. Thoracoscope shows pleural thickening and neoplasm. But the diagnosis depends on histopathological biopsy and immunohistochemical analysis of larger specimens.