Pulmonary leiomyosarcoma arising in pulmonary hamartoma: an exceptional occurrence in a rare tumor.

IF 4.4 Q1 PATHOLOGY PATHOLOGICA Pub Date : 2023-12-01 DOI:10.32074/1591-951X-941
Stefano Lucà, Marco Montella, Riccardo Monti, Marina Accardo, Giovanni Savarese, Roberto Sirica, Alfonso Fiorelli, Floriana Morgillo, Renato Franco
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Abstract

A solitary peripheral lung nodule was found in the left lung of a 52-year-old man. It was located in the lower lobe and measured 18.5 cm of major axis on chest computed tomography. A tru-cut core biopsy was obtained and a proliferation of bland, monomorphic, spindle cells in interlacing fascicles was observed. Accordingly, a surgical resection of the neoplasm was subsequently carried out. Macroscopically, the tumor appeared as a well-circumscribed nodule with a firm and whitish cut surface. Histologically, the neoplasm was predominantly composed of bland and monomorphic spindle cells, with a predominantly fascicular growth pattern, in which many tubular and cleft-like spaces of entrapped normal respiratory epithelium were involved. Myxoid change, stromal hyalinization and scattered bizarre mononucleated and multinucleated cells were also observed. Based on clinico-morphological, immunophenotypical and molecular features, we made a diagnosis of malignant transformation of pulmonary adenoleiomyomatous hamartoma into pulmonary leiomyosarcoma. As far as we know, this is the first described case of this exceptionally rare occurrence in an already rare neoplasm.

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肺火腿肠瘤中出现的肺亮肌肉瘤:罕见肿瘤中的罕见病例。
在一名 52 岁男子的左肺中发现了一个单发的周边肺结节。该结节位于肺下叶,胸部计算机断层扫描显示其主轴长 18.5 厘米。对该结节进行了切核活检,观察到平滑、单形、纺锤形细胞增生,呈交错束状。因此,随后对肿瘤进行了手术切除。从宏观上看,肿瘤是一个圆形结节,切面坚硬,呈白色。组织学上,肿瘤主要由平淡无奇的单形纺锤形细胞组成,以束状生长为主,其中有许多管状和裂隙状的正常呼吸道上皮细胞。此外,还观察到肌样变、基质透明化以及散在的奇异单核和多核细胞。根据临床形态学、免疫表型和分子特征,我们诊断为肺腺泡肌瘤恶性转化为肺亮肌肉瘤。据我们所知,这是第一例在一种已经非常罕见的肿瘤中发生这种异常罕见情况的病例。
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来源期刊
PATHOLOGICA
PATHOLOGICA PATHOLOGY-
CiteScore
5.90
自引率
5.70%
发文量
108
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