Pulmonary benign metastasizing leiomyoma:a report of 7 cases and literature review
Objective To investigate the clinicopathological features,immunophenotype,pathogenesis,differentiation and management of pulmonary benign metastasizing leiomyoma(PBML).Methods The medical records and speci-men data of 7 cases of PBML treated in the Department of Pathology,The First Affiliated Hospital of Soochow Univer-sity during Aug.2015 and Jan.2022 were collected.All patients were female,aged 35 to 62 years(median 53 years),and all had a history of uterine leiomyoma surgery.The diagnosis was confirmed with chest CT,histopathology and im-munohistochemistry.The imaging,pathological features and immunophenotypes were analyzed,and relevant literature was collected.Results CT images showed single or multiple quasi-circular hyperdense lesions of varying sizes.PBML was morphologically analogous to uterine leiomyoma.Immunohistochemically,all 7 cases were diffusely and strongly positive for Desmin and SMA.All 7 cases were ER positive,4 cases were PR positive;1 case had Ki-67 proliferation index of 10%,the other 6 had 1%-5%.All cases were negative for S-100,CD117,CD34 and HMB45.The diagnosis of this disease required a combination of history,imaging,pathology,and immunohistochemistry,and needed to be differentiated from leiomyosarcoma,fibroleiomyomatous hamartoma,inflammatory myofibroblastic tumor,and solitary fibrous tumor.The prognosis of PBML was generally favorable.Conclusion If CT images show single or multiple qua-si-circular hyperdense lesions of varying sizes and the patient has a history of uterine fibroids or surgery,the possibility of PBML should be considered.Surgical resection is preferred for treatment.
Benign metastasizing leiomyomaRare pulmonary diseasePathological featuresImmunohistochemistryWedge resection of lung
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