Wolff M, Silva F, Kaye G
Am J Surg Pathol. 1979 Aug;3(4):325-42. doi: 10.1097/00000478-197908000-00004.
This study pertains to an entity characterized by the presence of multiple intrapulmonary nodules, which consist of an admixture of bundles of well-differentiated smooth muscle cells and epithelial-lined spaces. These lesions have been frequently interpreted as a variant of hamartomas. However, in this review of the literature, and careful analysis of nine cases of this entity, we concluded that they should be considered metastases from smooth muscle tumors which incorporate some structures of mature lung parenchyma as they slowly expand. We affirm that the designation "fibroeliomyomatous hamartoma" should be discarded. Our cases occurred in six female and three male patients. In all but one female the primary source for lung metastases was uterus, while the male patients had primary lesions in the saphenous vein, diaphragm, and soft tissues. These lung lesions increase in size and number and are potentially fatal, though this may take many years. Even though the smooth muscle cells of the lung nodules appear bland on light microscopy, we were always able to demonstrate mitotic activity; electron microscopy indicated immaturity of the cells. For these reasons, we believe the tumors to represent metastatic leiomyosarcomas.
本研究涉及一种以存在多个肺内结节为特征的实体，这些结节由分化良好的平滑肌细胞束和内衬上皮的间隙混合组成。这些病变常被解释为错构瘤的一种变体。然而，在本次文献回顾及对该实体9例病例的仔细分析中，我们得出结论，它们应被视为平滑肌肿瘤的转移灶，这些肿瘤在缓慢生长过程中融合了一些成熟肺实质的结构。我们断言，“纤维性平滑肌瘤样错构瘤”这一命名应被摒弃。我们的病例中，6例为女性，3例为男性。除1名女性外，所有女性肺转移的原发部位均为子宫，而男性患者的原发病变分别位于大隐静脉、膈肌和软组织。这些肺部病变的大小和数量会增加，且可能致命，尽管这可能需要数年时间。尽管肺结节的平滑肌细胞在光镜下看似无异样，但我们总能发现有丝分裂活动；电镜显示细胞不成熟。基于这些原因，我们认为这些肿瘤代表转移性平滑肌肉瘤。
