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Primary pulmonary glomus tumor: a clinicopathologic
and immunohistochemical study of two cases.
Mod Pathol.1998 Mar;11(3):253-8.
We present two
cases of glomus tumors arising within the lung parenchyma. The
patients are a 40-year-old man and a 51-year-old man. Clinically,
the two men were asymptomatic, and the pulmonary tumor was detected
during a routine chest roentgenographic examination. Complete
surgical resection of the pulmonary tumors was performed. Grossly,
the tumors measured 1.1 and 1.5 cm. in greatest dimension; they were
well circumscribed and subpleural. Neither tumor showed evidence of
invasion of lung or pleura. Histologically, both tumors had
pseudocapsules, lacked invasion of surrounding lung structures, and
demonstrated the appearance of the solid/mucohyaline, or "glomus
tumor proper" type of neoplasm. This included oval-to-round cells,
with central uniform nuclei; variably eosinophilic-to-clear
cytoplasm; and well-demarcated cell borders in close proximity to a
rich vascular supply showing perivascular fibrosis.
Immunohistochemically, both tumors showed diffuse,
moderate-to-strong staining for vimentin, muscle-specific actin, and
smooth muscle actin. One tumor also showed diffuse strong staining
for desmin, whereas the other was negative. Follow-up information
obtained from one of the patients revealed that he was alive and
well 47 months after surgical resection. Our cases highlight the
ubiquitous distribution of glomus tumor and its similar histologic
appearance and immunohistochemical profile to soft tissue glomus
tumors.
Malignant glomus tumor of the lung.Pathol
Int. 2003 Sep;53(9):632-6
Primary
malignant glomus tumors of the lung are extremely rare, and to our
knowledge, only three cases have been described to date. We report
one such case in a 53-year-old man who presented with a persistent
dry cough. Chest computed tomography scans demonstrated an
irregularly shaped mass in the right lower lobe of the lung. Many
small nodules were distributed from the main tumor to the periphery,
along with bronchovascular bundles. Right lower lobectomy was
performed under the diagnosis of lung tumor. The tumor was located
in the proximal portion of the right lower lobe and extended along
the pulmonary arteries. Histological examination revealed a
sheet-like proliferation of epithelioid glomus cells and fascicles
of spindle cells. The presence of increased mitotic activity, tumor
necrosis and prominent intravascular invasion suggested malignancy.
The tumor cells were immunoreactive for vimentin, calponin, h-caldesmon,
and alpha-smooth muscle actin, which indicated definitive smooth
muscle differentiation. We believe that this is the fourth reported
case of malignant glomus tumor of the lung.
Primary
pulmonary glomus tumor with contiguous spread to a peribronchial
lymph node.
Ann Diagn Pathol. 2003 Aug;7(4):245-8.
Glomus
tumors are uncommon soft tissue tumors. Rare occurrences in visceral
organs including the respiratory tract have been reported. The vast
majority of these tumors are biologically benign. We report a case
of primary pulmonary glomus tumor with atypical features
characterized by mild nuclear atypia, local infiltration, and
contiguous spread to a peribronchial lymph node. The current
literature is reviewed.
Pulmonary
glomus tumour: a case initially diagnosed as carcinoid tumour.
Respirology. 2002 Dec;7(4):369-71.
Pulmonary
glomus tumours are rare lesions, with few cases reported previously.
Herein, we present the clinical and pathological features of a case
of pulmonary glomus tumour. A 29-year-old female patient presented
to our clinic complaining of cough, dyspnoea and left-sided chest
pain. Computed tomography (CT) of the thorax revealed a nodular
lesion causing obstruction of the left main bronchus. Fibreoptic
bronchoscopy demonstrated a polypoid mass occluding the left main
bronchus 10 mm distal to the main carina. Bronchoscopic biopsy was
interpreted histologically as carcinoid tumour. Bronchotomy plus
mass extirpation was performed with left thoracotomy.
Microscopically, a tumoral structure composed of uniform cells with
a round centrally located nucleolus and narrow eosinophilic
cytoplasm was seen. Thin-walled vessels lined with endothelium were
interspersed between tumoral structures. The cells were stained
chromogranin and cytokeratin negative and strongly vimentin
positive. The pathological diagnosis for the thoracotomy specimen
was pulmonary glomus tumour. Follow-up chest CT was negative for
recurrent tumour and the patient remains free of disease 17 months
after surgery.
Pulmonary and mediastinal glomus tumors--report of
five cases including a pulmonary glomangiosarcoma: a
clinicopathologic study with literature review.Am
J Surg Pathol. 2000 Aug;24(8):1105-14.
Pulmonary and
mediastinal glomus tumors are rare lesions, with four previously
reported primary pulmonary cases and three mediastinal cases. The
authors report one mediastinal glomus tumor, a locally infiltrative
type, and four pulmonary glomus tumors, including the first case of
primary pulmonary glomangiosarcoma. These tumors show a variety of
clinical and pathologic differences from the more common cutaneous
variety, including later age at presentation, larger size, and more
frequent atypical/malignant features. Mediastinal and pulmonary
glomus tumors both have an average patient age at presentation of 45
years. However, compared with their pulmonary counterparts,
mediastinal glomus tumors are less common, more often symptomatic,
and are larger (average size, 5.4 cm). Additionally, mediastinal
glomus tumors more often demonstrate malignant or atypical features.
Pulmonary glomus tumors average 3.3 cm in greatest dimension, with
the majority measuring less than 2.5 cm. The pulmonary
glomangiosarcoma presented was large, measuring 9.5 cm, and showed
increased mitotic count (9 mitoses/10 high-power fields), necrosis,
cytologic atypia, and was associated with disseminated disease.
Regardless of clinical symptoms, histologic features, and even
metastases, the vast majority of all benign and malignant glomus
tumors are indolent and cured surgically, with adjuvant therapy
needed only for occasional patients with more advanced disease. The
four patients with glomus tumors reported are currently alive and
free of disease as of last follow up. The patient with the
glomangiosarcoma developed widespread metastases and died of disease
68 weeks after initial therapy.
A
vascular lesion with smooth muscle differentiation presenting as a
coin lesion in the lung: glomus tumor versus hemangiopericytoma.Am
J Clin Pathol. 1983 Nov;80(5):765-71.
A 34-year-old
black man presented with an asymptomatic coin lesion in the lung.
The diagnosis was narrowed to a differential between glomus tumor
and hemangiopericytoma. The authors found that the terminology
applied to such tumors in the literature is confusing largely
because of lack of consistency in criteria used to establish the
diagnosis. The authors propose that the term glomus tumor be
reserved for tumors composed of endothelial-lined vascular spaces
surrounded by smooth muscle cells. Hemangiopericytoma should be used
for similar tumors composed of pericytes with or without other types
of perivascular mesenchymal cells. According to these criteria, this
case is the third glomus tumor reported in the lung.
Glomangioma of the lung.Am
J Surg Pathol. 1978 Mar;2(1):103-9.
An unusual
pulmonary tumor was identified on the basis of light and electron
microscopic findings as glomangioma. The ultrastructural findings of
intracytoplasmic fibrils with dense bodies, electron-dense plaques,
pinocytotic vesicles, and basement membranes are consistent with
smooth muscle origin. The differential diagnosis between our tumor
and other unusual tumors is discussed. The occurrence of a
glomangioma in the lung may indicate the existence of pulmonary
glomera.
Lung tumors derived from ectopic tissues.Semin
Diagn Pathol. 1995 May;12(2):172-84.
Ectopic tissues
rarely occur in the lung. They include endometriosis, neurological
tissue, thyroid, pancreas, and adrenal. Choristomas are very rare
developmental anomalies derived from these ectopic tissues. They
develop as a mass composed of histologically normal tissues that are
heterotopic in the lung. Various intrapulmonary neoplasms also
rarely develop from ectopic tissues. They include malignant
melanoma, thymoma, meningioma, glomus tumor, germ cell neoplasms (choriocarcinoma
and teratoma), and ependymoma. The clinicopathological features of
these unusual pulmonary neoplasms are discussed.
Glomangioma
of the lungs: a rare differential diagnosis of a pulmonary tumour.J
Clin Pathol. 2006 Sep;59(9):1000.
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