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Sicolo E, Mastromarino MG, Rabazzi G, Bacchin D, Ali G, Aprile V, Lucchi M. Case report: A giant lung leiomyosarcoma: From an accurate diagnosis to a successful surgery. A rare case and brief literature review. Front Surg 2022; 9:975982. [PMID: 36117833 PMCID: PMC9475251 DOI: 10.3389/fsurg.2022.975982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
Primary pulmonary leiomyosarcomas (PPLs) are incredibly rare tumors, characterized by an often-aggressive clinical behavior. Diagnosis is frequently incidental. Whenever present, symptoms are nonspecific, thus PPLs are usually misdiagnosed as other more common respiratory diseases or lung cancer subtypes. Surgery is the best treatment choice and in the therapeutic strategy, timeliness and radicality are of major importance. We report the case of a huge left PPL, successfully treated with salvage surgery after a careful multidisciplinary preoperative assessment, which permitted a prompt diagnostic path and surgery.
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Affiliation(s)
- Elisa Sicolo
- Thoracic Surgery Division, Cardiac, Vascular and Thoracic Department, University Hospital of Pisa, Pisa, Italy
| | - Maria Giovanna Mastromarino
- Thoracic Surgery Division, Cardiac, Vascular and Thoracic Department, University Hospital of Pisa, Pisa, Italy
- Correspondence: Maria Giovanna Mastromarino
| | - Giacomo Rabazzi
- Thoracic Surgery Division, Cardiac, Vascular and Thoracic Department, University Hospital of Pisa, Pisa, Italy
| | - Diana Bacchin
- Thoracic Surgery Division, Cardiac, Vascular and Thoracic Department, University Hospital of Pisa, Pisa, Italy
| | - Greta Ali
- Unit of Pathological Anatomy, University Hospital of Pisa, Pisa, Italy
| | - Vittorio Aprile
- Thoracic Surgery Division, Cardiac, Vascular and Thoracic Department, University Hospital of Pisa, Pisa, Italy
| | - Marco Lucchi
- Thoracic Surgery Division, Cardiac, Vascular and Thoracic Department, University Hospital of Pisa, Pisa, Italy
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2
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Ozluk E, Wei EX, Cotelingam J, Shackelford RE. Primary Pulmonary Leiomyosarcoma in a Forty-Year-Old Woman. Case Rep Oncol 2021; 14:1333-1336. [PMID: 34720937 PMCID: PMC8525287 DOI: 10.1159/000516273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 11/19/2022] Open
Abstract
Primary pulmonary leiomyosarcomas (PPLs) are rare aggressive malignancies originating from the smooth muscle cells of the pulmonary interstitium, bronchial tree, or blood vessels. Accounting for <0.5% of lung tumors, PPLs are often initially undetected or misdiagnosed as pulmonary emboli, cardiac neoplasms, or as other more common lung cancer subtypes. Due to their aggressive and often lethal clinical profile, the diagnostic delay of PPL can significantly affect patient outcomes and must be avoided. Here we describe a case of PPL in a 40-year-old woman.
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Affiliation(s)
- Ekin Ozluk
- Department of Pathology & Translational Pathobiology, LSU Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Eric X Wei
- Department of Pathology, University of South Alabama, Mobile, Alabama, USA
| | - James Cotelingam
- Department of Pathology & Translational Pathobiology, LSU Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Rodney E Shackelford
- Department of Pathology & Translational Pathobiology, LSU Health Sciences Center Shreveport, Shreveport, Louisiana, USA
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3
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Song KS, Keum DY, Hwang IS. Malignant Transformation of Pulmonary Benign Metastasizing Leiomyoma. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2017; 50:59-63. [PMID: 28180107 PMCID: PMC5295487 DOI: 10.5090/kjtcs.2017.50.1.59] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 04/08/2016] [Accepted: 04/12/2016] [Indexed: 11/16/2022]
Abstract
Pulmonary benign metastasizing leiomyoma (PBML) is defined as metastasis of a leiomyoma to lung tissue. It was first reported in 1937. P BML is known as a benign disease, but can undergo malignant transformation. Only 1 case of the malignant transformation of PBML to leiomyosarcoma has been reported previously. In this report, we present a case of malignant transformation of PBML.
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Affiliation(s)
- Kyung Sub Song
- Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine
| | - Dong Yoon Keum
- Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine
| | - Il Seon Hwang
- Department of Pathology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine
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4
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Xie X, Chen Y, Ding C, Yu X, Zou L, Xu B, Wang L, Huang X. Primary pulmonary leiomyosarcoma: A case report. Oncol Lett 2016; 11:1807-1810. [PMID: 26998080 DOI: 10.3892/ol.2016.4131] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 11/30/2015] [Indexed: 11/06/2022] Open
Abstract
Primary pulmonary leiomyosarcoma (PPL) is an extremely rare malignant tumor. It has been revealed that PPL may originate from the smooth muscle of the pulmonary parenchyma, pulmonary arteries and bronchi. Patients with PPL may be asymptomatic or present with symptoms similar to those observed in other primary lung tumors. The present study reports the case of a 48-year-old man who presented with a lung mass and underwent a right upper-middle lobe bronchoscope tumor resection. The patient was subsequently diagnosed with PPL. Following the bronchoscopic tumor resection, chemotherapy was administered to the patient; however, the patient succumbed to the disease after the second cycle of chemotherapy.
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Affiliation(s)
- Xiaona Xie
- Pulmonary Division, Zhejiang University of Traditional Chinese Medicine Affiliated with Wenzhou Hospital, Wenzhou, Zhejiang 325000, P.R. China
| | - Yanfan Chen
- Pulmonary Division, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Cheng Ding
- Pulmonary Division, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Xiaoming Yu
- Pulmonary Division, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Lizhen Zou
- Pulmonary Division, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Botao Xu
- Division of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Liangxing Wang
- Pulmonary Division, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Xiaoying Huang
- Pulmonary Division, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
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5
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Straight to the heart: pulmonary vein leiomyosarcoma. Am J Med 2013; 126:117-9. [PMID: 23331438 DOI: 10.1016/j.amjmed.2012.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 11/08/2012] [Accepted: 11/08/2012] [Indexed: 11/23/2022]
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6
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Giaj Levra M, Novello S, Scagliotti GV, Papotti M, Le Cesne A. Primary pleuropulmonary sarcoma: a rare disease entity. Clin Lung Cancer 2012; 13:399-407. [PMID: 22673623 DOI: 10.1016/j.cllc.2012.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 04/25/2012] [Accepted: 05/01/2012] [Indexed: 02/06/2023]
Affiliation(s)
- Matteo Giaj Levra
- University of Torino, Department of Clinical and Biological Sciences, Division of Thoracic Oncology, S. Luigi Hospital, Orbassano, Italy.
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7
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Foran P, Colleran G, Madewell J, O'Sullivan PJ. Imaging of Thoracic Sarcomas of the Chest Wall, Pleura, and Lung. Semin Ultrasound CT MR 2011; 32:365-76. [DOI: 10.1053/j.sult.2011.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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8
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Ma Y, Chen BB, Xu XP, Lin GW, Ji Y, Akesu S, Zen H. Therapy-related acute myeloid leukemia in a primary pulmonary leiomyosarcoma patient with skin metastasis. Chin J Cancer Res 2011; 23:236-8. [PMID: 23467305 DOI: 10.1007/s11670-011-0236-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2010] [Accepted: 02/18/2011] [Indexed: 11/25/2022] Open
Abstract
Primary pulmonary leiomyosarcoma (LMS) is a very unusual tumor. Although LMS has well-known metastatic potential, cutaneous metastasis is a remarkably uncommon. Exposure to cytotoxic agents could lead to "therapy-related myeloid neoplasm" (t-MN). Starting from 2008, the World Health Organization (WHO) has adopted the term to cover the spectrum of malignant diseases previously known as therapy-related acute myeloid leukemia (t-AML), therapy-related myelodysplastic syndrome (t-MDS) and therapy-related myelodysplastic/myelo- proliferative neoplasm (t-MDS/MPN). We described the onset of t-MDS and progression to t-AML in one case diagnosed as primary pulmonary LMS with cutaneous metastasis. This patient achieved complete remission (CR) after three courses of IA regimen chemotherapy (idarubicin 5 mg/d, d 1-3; cytarabine 100 mg/d, d 1-5) and 1 course of HA chemotherapy regimen (homoharringtonine 3 mg/d, d 1-3; cytarabine 100 mg/d, d 1-7). This case presents the natural course of therapy-related neoplasm and provides therapeutic experience for t-AML.
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Affiliation(s)
- Yan Ma
- Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China
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9
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Rozada R, Vila A, Sosa L. [Primary leiomyosarcoma of the lung]. Arch Bronconeumol 2010; 46:338-9. [PMID: 20092929 DOI: 10.1016/j.arbres.2009.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 12/07/2009] [Accepted: 12/09/2009] [Indexed: 10/19/2022]
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10
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Ketata W, Msaad S, Kwass H, Bahri Zouari I, Abbes K, Yangui I, Boudawara T, Ayoub A. [Primary pulmonary leiomyosarcoma revealed by spontaneous pneumothorax]. REVUE DE PNEUMOLOGIE CLINIQUE 2009; 65:309-312. [PMID: 19878807 DOI: 10.1016/j.pneumo.2009.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Revised: 05/25/2009] [Accepted: 05/25/2009] [Indexed: 05/28/2023]
Abstract
We report the case of a 57-year-old patient admitted for dyspnea and dry cough. Thoracic radiograph showed a right pneumothorax and right paracardiac opacity. Thoracic drainage was carried out allowing the return of the lung at the wall. Chest CT-scan revealed right upper mediastinopulmonary mass taking contrast material associated with a nodular thickening of the pleura. CT-guided biopsy of the mass and the pleural nodules concluded to pulmonary leiomyosarcoma. Death occurred one month after diagnosis confirmation. Pneumothorax is a usual mode of revealing sarcoma's pulmonary metastases; however, it is exceptionally associated with primitive pulmonary sarcomas. Our case is the second published case, to our knowledge, of primitive pulmonary leiomyosarcoma presenting with pneumothorax.
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Affiliation(s)
- W Ketata
- Service de Pneumoallergologie, CHU Hédi Chaker, Sfax, Tunisia.
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11
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Daniels JT, Bajwa A, Cury JD. EMERGENT BRONCHOSCOPIC DEBULKING OF A PRIMARY PULMONARY LEIOMYOSARCOMA SECONDARY TO BILATERAL MAINSTEM BRONCHUS OBSTRUCTION. Chest 2008. [DOI: 10.1378/chest.134.4_meetingabstracts.c50002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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12
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Takeda F, Yamagiwa I, Ohizumi H, Shiono S. Leiomyosarcoma of the main bronchus in a girl: a long-time survivor with multiple lung metastases. Pediatr Pulmonol 2004; 37:368-74. [PMID: 15022135 DOI: 10.1002/ppul.10456] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Primary leiomyosarcoma of the respiratory tract is a very rare malignancy, especially in childhood, with only 15 cases in patients under 16 years old having been reported. In the present case, the survival period from the onset of symptoms has been over 7 years, despite incomplete resection. Based on the 15 published cases, the prognosis is poorer when the tumor is unresected or incompletely resected, but under favorable circumstances, prolonged survival is possible.
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Affiliation(s)
- Fumihiro Takeda
- Department of Thoracic and Cardiovascular Surgery, Tsuruoka Municipal Shonai Hospital, Tsuruoka, Japan.
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13
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Lee KH, Song KS, Kwon Y, Lee I, Lee JS, Lim TH. Mesenchymal Tumours of the Thorax:CT Findings and Pathological Features. Clin Radiol 2003; 58:934-44. [PMID: 14654025 DOI: 10.1016/s0009-9260(03)00292-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mesenchymal tumours of the thorax are uncommon and may originate from the muscle, bone, cartilage, vessel, nerves, fat and fibrous tissue. These tumours occur at different sites including the lung, pleura, mediastinum or chest wall. Mesenchymal tumours tend to show protean and non-specific imaging characteristics. However, in some instances, the imaging characteristics of the tumour may allow a specific diagnosis to be made, such as with lipoid or vascular tumours.
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MESH Headings
- Adolescent
- Adult
- Female
- Humans
- Male
- Middle Aged
- Neoplasms, Adipose Tissue/diagnostic imaging
- Neoplasms, Adipose Tissue/pathology
- Neoplasms, Connective and Soft Tissue/diagnostic imaging
- Neoplasms, Connective and Soft Tissue/pathology
- Neoplasms, Fibrous Tissue/diagnostic imaging
- Neoplasms, Fibrous Tissue/pathology
- Neoplasms, Muscle Tissue/diagnostic imaging
- Neoplasms, Muscle Tissue/pathology
- Neoplasms, Vascular Tissue/diagnostic imaging
- Neoplasms, Vascular Tissue/pathology
- Thoracic Neoplasms/diagnostic imaging
- Thoracic Neoplasms/pathology
- Tomography, X-Ray Computed/methods
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Affiliation(s)
- K-H Lee
- Department of Radiology, Inha University Hospital, Shinheung-dong, Joong-gu, Inchon, South Korea
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14
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Muscolino G, Bedini AV, Buffa PF. Leiomyosarcoma of the bronchus: report of two cases of resection with long-term follow-up. J Thorac Cardiovasc Surg 2000; 119:853-4. [PMID: 10733781 DOI: 10.1016/s0022-5223(00)70025-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- G Muscolino
- Department of Thoracic Surgery, National Cancer Institute, Milan, Italy
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15
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Abstract
Five smooth muscle tumours presenting as pleural neoplasma are presented. The patients were three women and two men aged between 21 and 69 years (mean = 45 years). Clinically, one patient presented with chest pain, one with empyema and the other three were asymptomatic. Two of the tumours were located in the left side of the chest cavity and three in the right side. In four cases, the lesions presented as solitary pleural-based masses that varied in size from 10-18 cm in greatest dimension: in two of these cases, involvement of the diaphragm was present in addition to the pleural involvement. In one case, the tumour was seen to totally encase the right lung simulating the growth pattern of malignant mesothelioma. Histologically, three cases displayed an atypical spindle cell proliferation with marked cellular pleomorphism, mitoses and areas of hemorrhage and necrosis. The other two cases were characterized by a bland-appearing smooth muscle proliferation of uncertain malignant potential composed of elongated cells with a moderate amount of eosinophilic cytoplasm and cigar-shaped nuclei, lacking significant nuclear pleomorphism or mitotic activity. Immunohistochemical studies showed strong positivity for alpha-smooth muscle actin in all cases, and for desmin in four of five cases, and a focal positive reaction for keratin in one case. Ultrastructural examination in one of the high-grade tumours showed features of smooth muscle differentiation. Three of the patients were treated by complete surgical excision while, in the other two patients, the lesions were incompletely resected.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C A Moran
- Department of Pulmonary & Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA
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17
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Shukla V, Chandran S, Varma S, Lal N, Chandi SM, Korula RJ. Primary bronchial leiomyosarcoma. Indian J Thorac Cardiovasc Surg 1993. [DOI: 10.1007/bf02666037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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18
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Warren WH, Bleck P, Kittle CF, Faber LP. Surgical management of pulmonary metastatic leiomyosarcoma with gross endobronchial extension. Ann Thorac Surg 1990; 50:739-42. [PMID: 2241334 DOI: 10.1016/0003-4975(90)90674-u] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Metastatic leiomyosarcoma occasionally is seen with gross endobronchial extension without invasion of the bronchial wall. These patients have major airway obstruction and partial or total atelectasis of the lung. Precise bronchoscopic assessment coupled with intraoperative bronchotomy allows the surgeon to determine the origin of the tumor and to save uninvolved pulmonary parenchyma. Our experience with 4 such patients illustrates the possibility of saving lung tissue despite total bronchial obstruction.
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Affiliation(s)
- W H Warren
- Department of Cardiovascular-Thoracic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois
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19
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Capewell S, Webb JN, Crompton GK. Primary leiomyosarcoma of the lung presenting with a persistent pneumothorax. Thorax 1986; 41:649-50. [PMID: 3787547 PMCID: PMC460416 DOI: 10.1136/thx.41.8.649] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
Leiomyosarcoma of the lung is a type of tumour rarely found in childhood. It arises from smooth muscle either of bronchial or arterial walls, has a variable pattern of local growth, blood-borne metastatic spread with lymph nodes sparing and a clinical course characterized by fever, cough and worsening dyspnea. We report a case which occurred in a 14-year-old girl, reviewing all the other cases found in the literature.
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Møller Pedersen V, Schulze S, Høier Madsen K, Krogdahl AS. Primary pulmonary leiomyosarcoma. Review of the literature and report of a case. SCANDINAVIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 1984; 18:251-4. [PMID: 6528273 DOI: 10.3109/14017438409109902] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In a review of the literature, 38 cases of pulmonary leiomyosarcoma were found. An additional case with highly progressive course is reported and the diagnostic and therapeutic possibilities are discussed. Prognostic signs are evaluated. The importance of radical surgery is emphasized.
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22
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Yellin A, Rosenman Y, Lieberman Y. Review of smooth muscle tumours of the lower respiratory tract. ACTA ACUST UNITED AC 1984. [DOI: 10.1016/0007-0971(84)90166-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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23
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Abstract
Primary tumors of the lung rarely occur in children. However, 230 well-documented cases, including the 2 presented in this review, have been identified in the English-language literature. One hundred fifty-one tumors in these reports were classified as malignant lesions and 79 as benign neoplasms. Bronchial "adenomas" constituted the largest group; most of these lesions were of the carcinoid variety, and 8% were definitely malignant. Forty-seven cases of bronchogenic carcinoma were reported in children under 16 years of age, although there were few squamous cell tumors (12%). Fifty-six percent of the benign tumors were classified as inflammatory pseudotumor. Most of the children in this collective series were seen with symptoms related to bronchial irritation or obstruction, such as cough, hemoptysis, atelectasis, or pneumonitis. Respiratory distress was an unusual symptom that was often associated with large tumors seen in the neonatal period. Approximately 20% of the children were totally symptomatic. The limited survival data that are available indicate that leiomyosarcoma and mucoepidermoid carcinoma have a more favorable prognosis in children than in adults. Survival with bronchial carcinoid tumors (90%), bronchogenic carcinoma (30%), and pulmonary blastoma (45%) appears to parallel that for adults. The experience with pulmonary rhabdomyosarcoma, as described in this review, emphasizes the importance of early diagnosis and the use of combined modes of therapy in the approach to these malignancies. Despite the rarity of primary pulmonary neoplasms in children, this diagnosis should be considered in young patients with solitary pulmonary masses or persistent, atypical pulmonary symptoms. It is hoped that early diagnosis will result in an improved prognosis and prevent life-threatening complications.
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Abstract
Four cases of pulmonary leiomyosarcoma are presented. The characteristic histological features are described with specific reference to the criteria of malignancy. It is suggested that diagnosis by bronchoscopy provides insufficient material for histological grading and open lung biopsy is the diagnostic tool of choice. The available methods of treatment are discussed.
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Bedrossian CW, Verani R, Unger KM, Salman J. Pulmonary malignant fibrous histiocytoma. Light and electron microscopic studies of one case. Chest 1979; 75:186-9. [PMID: 217571 DOI: 10.1378/chest.75.2.186] [Citation(s) in RCA: 42] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
A malignant fibrous histiocytoma (MFH) arising in the lungs of a 51-year-old man was studied by light and electron microscopy. Features observed were identical to those of MFHs which occur in the skin and subcutaneous tissue and less commonly in other deep locations. By light microscopy, a storiform pattern with admixture of fibroblasts and histiocytes, as well as xanthomatous and giant cells, was noted. Undifferentiated tumor cells along with fibroblasts and histiocytes in different degrees of differentiation were identified ultrastructurally. These findings lend support to the concept that MFH is a sarcoma of primitive mesenchymal cell origin. The addition of the lung as another primary site for the development of this tumor is consistent with the view that MFHs may potentially arise in any part of the body.
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