Primary pulmonary leiomyosarcoma. Review of the literature and report of a case

Metastatic pulmonary leiomyosarcoma: cytopathologic diagnosis on sputum examination

Pulmonary metastasis of sarcomas is not uncommon. Rarely, endobronchial involvement may result in exfoliation of diagnostic cells in sputum. This case report is of a 71-yr-old man with a history of lower leg leiomyosarcoma who developed multiple lung metastases. Sputum examination revealed malignant cells with pleomorphic, elongated, and cigar-shaped nuclei and occasional bipolar cytoplasmic processes. Immunoperoxidase studies on the smears using desmin and smooth muscle actin were strongly positive, consistent with leiomyosarcoma. Confirmation of metastatic lung disease by sputum cytology not only has prognostic importance but also obviates the need for further investigations.

Miliary pattern as presentation of leiomyomatosis of the lung

A 30-year-old woman presented with progressive dyspnea on exertion and a rapidly-growing uterine mass. Chest x-ray examination revealed a miliary interstitial nodular pattern in both lung fields. Transbronchial biopsy yielded lung tissue containing multiple nodules of smooth muscle, consistent with benign metastasizing leiomyoma. Subsequent hysterectomy revealed an atypical cellular leiomyoma. We wish to emphasize the need for chest x-ray examination in the workup of uterine tumors in women of reproductive age.