Autopsy findings in a rare case of pleomorphic carcinoma in a patient on dialysis

Key Clinical Message Pleomorphic lung cancer is a very rare type of cancer and very few cases have been reported in the literature. We present a case of pleomorphic lung cancer in a patient with history of IgA nephropathy on hemodialysis. Malignancy is the most common cause of death in Japan and it is the 3rd leading cause of death in patients with End Stage Kidney disease in Japan. Pleomorphic lung cancer is a very rare type of cancer and very few cases have been reported in the literature. We present a case of pleomorphic lung cancer in a patient with history of Ig A nephropathy on hemodialysis. Chest computed tomography (CT) revealed a new heterogeneous mass extending from the right lower lobe to the posterior mediastinum and carina, as well as enlarged mediastinal and hilar lymph nodes, compared with the chest CT scan 1 year earlier. Endobronchial ultrasound‐guided transbronchial needle aspiration biopsy of a mediastinal lymph node revealed proliferation of large round‐like and spindle‐shaped cells. Immunostaining was positive for Thyroid transcription factor‐1 (TTF1) and CK 7 but was negative for sarcoma.