Review of histologic and immunohistochemical features of spindle cell carcinomas (carcinosarcomas) of the larynx

Background: Laryngeal carcinosarcomas pose a significant diagnostic challenge to the pathologist; differential diagnosis needs histochemical and immunohistochemical investigations.

Materials and Methods: A retrospective review of charts of the pathology database was performed by a search for carcinosarcoma cases. Immunohistochemistry was performed on the representative paraffin blocks in all cases.

Results: This study included a total of 5 cases of carcinosarcomas of the larynx. The sarcomatoid component of the tumor was arranged in various patterns mimicking mesenchymal malignancies. Tumor cells were seen arranged in fascicles (a patient), in a storiform (3 patients), or in a solid (a case) pattern. The epithelial markers EMA and AE1/AE3 were positive in all 5 patients, as well as vimentin and CK34betaE12.

Discussion: Immunohistochemical studies of epithelial and mesenchymal markers (such as AE1/AE3, epithelial membrane antigens, vimentin, desmin, and S-100) are fundamental to diagnose the tumor, although they may widely vary.