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Benign and malignant mixed tumours of the lung
  1. P. W. Davis,
  2. J. C. Briggs,
  3. R. M. E. Seal,
  4. F. K. Storring
  1. Llandough and Sully Hospitals, Cardiff
  2. Frenchay Hospital, Bristol

    Abstract

    Ten patients are presented with tumours complying with the criteria established by the World Health Organization for `mixed tumours of the lung'.

    A slowly growing intrabronchial neoplasm indistinguishable from a pleomorphic adenoma (mixed salivary tumour) and a peripheral circumscribed tumour with most of the features of a chondromatous hamartoma were considered benign.

    Of eight malignant neoplasms two were regarded as `pulmonary blastomas', one with a benign epithelial tubular component and the other with cytological evidence of malignancy in the tubular epithelium; in both, the stroma was `embryonic' and pleomorphic. Three tumours were considered carcinosarcomas with a mainly epidermoid epithelial component and a pleomorphic spindle-cell connective tissue component. In the remaining three tumours the malignant epithelial component showed mixed, viz., epidermoid, tubular, and a variety of undifferentiated appearances, while the `stroma' exhibited features seen in both blastomas and carcinosarcomas. These three neoplasms were considered `transitional'.

    The spectrum of appearances encountered constitutes, in our opinion, a serious objection to the thesis that peripheral pulmonary blastomas and carcinosarcomas are distinct entities with a separate histogenesis. Exceptions were found to `blastomas' being peripheral and carcinosarcomas being central growths. A case is made for reclassification of the benign and malignant neoplasms included in the WHO group IX `mixed tumours of the lung'.

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