<B>Metastatic Sarcoma to Lung </B>

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Metastatic Sarcoma to Lung

Etiology:

• Dependent on original location and cell type.

Pathogenesis:

• Neoplasms acquire access to venous drainage and spread to lung
• Unknown why the vast majority of sarcomas do not spread via lymphatics

Epidemiology:

• Metastases to the lungs occurs in all sarcomas that spread outside their local area of origin.

General Gross Description:

• Usually multifocal lesions scattered through the periphery of the lung
• May be more frequent in the lower lobes where blood supply is richer
• Well circumscribed nodules which may be fleshy, glassy and cartilaginous, or bony depending on the histology of the primary lesion

General Microscopic Description:

• Range from spindle cell to chondrocytes or osteoblasts
• All show cytologic features of malignancy including enlarged irregular nuclei, prominent nucleoli, and mitotic activity.
• Necrosis may be prominent particularly if previous chemotherapy

Clinical Correlations:

• Although metastatic sarcoma to lungs is generally associated with a poor prognosis, some patients are still responsive to high dose chemotherapy followed by surgery to remove the nodules.

References:
• Cotran RS, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease. 5th edition. W.B. Saunders. Philadelphia 1994. pp.727-8.