|
A case of primary pulmonary leiomyosarcoma with
history of pneumonia 5 years before.Nihon
Kokyuki Gakkai Zasshi. 2004 May;42(5):419-2
A 35-year-old
woman with past history of pneumonia in the right lung field 5 years
before was admitted to our hospital because of fever and cough.
Chest radiographs showed a pulmonary tumor with atelectasis of the
right lower lung. Chest CT also revealed a round clear-edged tumor
at the right S6 with atelectasis of the right lower lung lobe.
Bronchoscopic findings showed a yellowish endobronchial tumor in the
right truncus intermedius, which proved to be leiomyosarcoma. We
could not find any other malignant lesion, and therefore, on a
diagnosis of primary pulmonary leiomyosarcoma, right middle and
lower lobectomy was performed with lymph node excision.
Retrospective examination of the chest radiographs revealed not only
that the original region of the leiomyosarcoma seemed to be near the
site of the earlier pneumonia, but also that the atelectasis-like
findings 2 years before were similar to the findings on this
admission. It was reported that, if an operation could not be
performed at an early stage, the prognosis might be poor. In the
follow-up of the abnormal chest radiographic findings, the clinic
physician should observe the symptoms from the same viewpoint as
hospital doctors. It is important to keep an active relationship
between clinic and hospital. We might have reached our final
diagnosis earlier if we had been more active in seeking an
examination for abnormal chest radiographic findings, without
attaching too much importance to the patient's age.
Primary pulmonary leiomyosarcoma. Report of a case
diagnosed by fine needle aspiration cytology.Acta
Cytol. 2002 Sep-Oct;46(5):912-6.
BACKGROUND:
Primary pulmonary leiomyosarcoma is a rare but important entity. We
report a case diagnosed by fine needle aspiration cytology. CASE: A
73-year-old male presented with an asymptomatic, right, pulmonary,
subpleural nodule detected by computed tomography during follow-up
for chronic obstructive pulmonary disease. Fine needle aspiration
cytology showed cellular smears with numerous single or loosely
cohesive groups of spindle-shaped to round cells. The tumor cell
nuclei were blunt ended (cigar shaped), with fine to fine-granular
chromatin, prominent nucleoli and an irregular nuclear rim. The
tumor cells were positive for desmin and negative for cytokeratin
and S-100 protein by immunocytochemistry. Right upper lobectomy with
lymph node dissection was performed. Pathologic diagnosis after
microscopic, immunohistochemical and electron microscopic studies
was leiomyosarcoma. CONCLUSION: To our knowledge, this is the first
reported case of primary pulmonary leiomyosarcoma arising in the
subpleural region diagnosed by fine needle aspiration cytology.
Immunocytochemistry was useful in establishing the diagnosis in this
case.
Radiologic findings in primary pulmonary
leiomyosarcoma.J
Thorac Imaging. 2000 Apr;15(2):151-2.
Leiomyosarcomas
are uncommon smooth muscle tumors most commonly encountered in the
female genital organs, gastrointestinal tract, and soft tissues.
They are rarely encountered as primary pulmonary neoplasms. Herein
we describe the conventional radiographic and computed tomographic
findings in a patient with a pulmonary leiomyosarcoma.
Pulmonary leiomyosarcoma.Chin
Med Sci J. 1997 Jun;12(2):129-31
Three cases of
pulmonary leiomyosarcoma were presented. The characteristic clinical
features were described with review of literature. In comparison
with bronchogenic carcinoma, the leiomyosarcoma has some
characteristics: 1) On chest X-ray, it usually appears as a sharply
demarcated, even density round mass, growing rapidly within the
lung, it unusually accompanies with hilar or mediastinal lymph node
metastasis; 2) The preoperative cytological or pathological
diagnosis is difficult either by sputum smear or by bronchoscopic
biopsy or by fine needle percutaneous aspiration biopsy; 3)
Pathological differential diagnosis of leiomyosarcoma of lung from
anaplastic lung cancer is difficult. In conclusion, the primary
pulmonary leiomyosarcoma is a rare malignant tumor, detecting the
present illness seriously, paying attention to the chest X-ray films
characterize, early surgical resection is the only way to get
diagnosis and effective treatment method.
Pulmonary leiomyosarcoma--report of three cases.Chin
Med Sci J. 1996 Sep;11(3):191-4
Three cases of
pulmonary leiomyosarcoma were presented. The characteristic clinical
features were described with review of literature. In comparison
with bronchogenic carcinoma, the leiomyosarcoma has some
characteristics: 1) On chest X-ray, it usually appears as a sharply
demarcated, even density round mass, growing rapidly within the
lung, it rarely accompanies with hilar or mediastinal lymph node
metastasis. 2) The preoperative cytological or pathological
diagnosis is difficult either by sputum smear or by bronchoscopic
biopsy or by fine needle percutaneous aspiration biopsy. 3)
Pathological differential diagnosis of leiomyosarcoma of lung from
anaplastic lung cancer is difficult. In conclusion, the primary
pulmonary leiomyosarcoma is a rare malignant tumor, detecting the
present illness seriously, paying attention to the chest X-ray films
characterize, early surgical resection is the only way to get
diagnosis and effective treatment method.
Pulmonary leiomyosarcoma.Arch
Bronconeumol. 1994 Nov;30(9):465-7
We present the
case of a young patient with leiomysarcoma of the lung that was at
first diagnosed as a hydatid cyst. Pathological tissue analysis was
needed for firm diagnosis. This rare tumor, of which fewer than 100
cases have been reported worldwide in the literature, needs to be
considered as a differential diagnosis when lung cancer is
suspected, given that leiomysarcoma has a better prognosis.
Treatment is mainly surgical.
A
case of pulmonary leiomyosarcoma followed up for five years.Nippon
Kyobu Geka Gakkai Zasshi. 1992 Nov;40(11):2066-9
A 70-year-old
woman with leiomyosarcoma, followed up for 5 years as tuberculoma,
is described. The tumor, in the left lower lobe, had enlarged from
1.5 x 1.5 cm to 3.4 x 3.4 cm in 5 years, and doubling time was
calculated to be 540 days. Another tumor (1.8 x 1.8 cm) was also
recognized in the right lower lobe at the later time. Since not only
a benign tumor but metastatic disease was suspected, thoracotomy was
performed, and the intraoperative pathologic diagnosis was
leiomyosarcoma. However, only partial lung resection was performed
because of the low growth rate of the tumor, the patient's advanced
age, limited lymphatic metastasis and favorable prognosis with only
partial resection. DNA analysis of the tumor based on flow cytometry
showed a diploid pattern, and this was thought to account for the
long doubling time of the tumor. The postoperative course was
satisfactory without any signs of recurrence at the operation site.
Two cases of
pulmonary leiomyosarcoma.Nippon
Kyobu Geka Gakkai Zasshi. 1990 Jul;38(7):1203-8
Pulmonary
sarcoma is a rare tumor of the lung. There are 81 cases in the
literature for review, including our two cases. Our first case who
was a thirty-seven year old male who was admitted to our hospital
with complaints of left back pain. His chest X-ray showed an 11 X 14
cm tumor shadow in the lower left lung area. A left upper lobectomy
was performed, and the histological diagnosis was leiomyosarcoma of
the pulmonary vein. He died due to mediastinal recurrence 29 months
later. Our other case was a fifty-six year old female. Her chest
X-ray showed an abnormal shadow that was a tumor shadow in the right
central lung area of 4 cm in diameter. As the diagnosis of the
transcutaneous lung biopsy was benign tumor, partial resection of
lung was performed. The histological diagnosis was leiomyosarcoma of
the bronchus, and she is alive and well at 29 months after the
operation. As the rate of diagnosis in leiomyosarcoma detected by
transcutaneous lung biopsy is low, the most acceptable method of
diagnosis is a total examination, including cytology of sputum,
bronchoscopic findings, and roentgenoscopy. Probe thoracotomy would
also be necessary if malignancy could not ruled out. The treatment
of lobectomy should include lymph node resection.
Primary
pulmonary leiomyosarcoma. Review of the literature apropos of a
case.J
Chir (Paris). 1987 Apr;124(4):272-5
A 55-year-old
patient with primary pulmonary leiomyosarcoma was treated by
pneumonectomy. The diagnosis was established by histology of the
operative piece. Bronchoscopy and cytology of expectorations were
negative. This rare tumor (fewer than 100 cases described) differs
from bronchial carcinoma by its method of spread, mainly hematogenic,
and its better prognosis. clinical and radiographic data do not
provide differential diagnoses. Treatment is essentially surgical
since the tumor is only weakly radio-sensitive and responds poorly
to chemotherapy.
|
