Carcinoma epidermóide sarcomatóide da Laringe. Estudo ultra-estrutural e imuno-histoquímico
DOI:
https://doi.org/10.32635/2176-9745.RBC.1988v34n2/3.3156Keywords:
Sarcomatoid Carcinoma of Larynx, Larynx, Malignant NeoplasiaAbstract
The sarcomatoid squamous cell carcinoma of the larynx is a rare tumor that still raises controversies among pathologists. Many names have been used to describe this lesion such as carcinosarcoma, spindle cell carcinoma, sarcomatoid carcinoma, pseudosarcoma, squamous cell carcinoma with sarcoma-like stroma, pleomorphic carcinoma, polypoid carcinoma and metaplastic carcinoma. The characteristic histopathologic finding is the presence ofa squamous cell carcinoma in association with a spindle cell pattern. It is here reported the case of a 59-year old white male who complained of one year disphony, as well as dysphagia and dyspnoea. The indirect examination of the larynx revealed a huge tumor with partial destruction of the glotis which proved to be a well differentiated squamous cell carcinoma with anaplastic spindle cell areas at light microscopy. There was also a peri-tracheal metastatic mass composêd exclusively of the spindle cell pattern. Samples of this mass were further analysed by immuneperoxidase and electron microscopy. The latter revealed the presence of groups of juxtaposed cells United by infrequent well defined desmosomes. They aIso exhibited irregular nuclei and distended RER. The immuneperoxidase staining for high molecullar weight cytokeratin showed'positivity for scattered individual cells in the areas of the exclusive spindle cell pattern. The present case brings evidences in favourof mesenchimal metapiasia in the squamous cell carcinoma of the larynx contributing to the discussion on the histogenesis of this neoplasia.
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