Mikami I, Yamamoto M, Nishimura H, Koizumi K, Gomibuchi M, Tanaka S
Department of Thoracic Surgery, Saitama Cancer Center, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Jul;46(7):634-8. doi: 10.1007/BF03217793.
The patient is a 50-year-old female who presented with cough. A chest X-ray showed bilateral multiple modular shadows. Even though a diagnosis of metastatic lung tumors was strongly suspected no primary lesion could be detected on close examination. Therefore, an exploratory thoracotomy, and histopathological examination of a specimen obtained from a resected tumor were carried out. The resected tumor revealed pathological proliferation of spindle cells without high cellularity or mitosis with nuclear atypism. The patient had a history of surgery for uterine leiomyoma at the age of 33. The histopathological characteristics of the resected lung tumors were remarkably similar to those of the previously resected uterine leiomyoma. In addition, the serum levels of sex hormones, including LH, measured after lung surgery, were within normal range suggesting the possibility of the lung tumors being metastatic. The residual lung tumors did not show any increase in size 26 months after surgery. Therefore, these lung tumors could be considered as lung metastases from a low grade malignant uterine leiomyoma (benign metastasizing leiomyoma).
该患者为一名50岁女性,因咳嗽就诊。胸部X光显示双侧多发结节状阴影。尽管强烈怀疑为转移性肺肿瘤,但仔细检查未发现原发病灶。因此,进行了开胸探查,并对切除肿瘤的标本进行了组织病理学检查。切除的肿瘤显示梭形细胞病理性增生,无高细胞密度或核异型性的有丝分裂。该患者33岁时曾接受子宫平滑肌瘤手术。切除的肺肿瘤的组织病理学特征与先前切除的子宫平滑肌瘤非常相似。此外,肺手术后测定的包括促黄体生成素(LH)在内的性激素血清水平在正常范围内,提示肺肿瘤有转移的可能性。术后26个月,残留的肺肿瘤大小未出现任何增加。因此,这些肺肿瘤可被认为是低级别恶性子宫平滑肌瘤(良性转移性平滑肌瘤)的肺转移瘤。