Lung

Mesenchymal tumors

Multiple pulmonary leiomyomatous hamartomas



Topic Completed: 1 August 2016

Minor changes: 30 September 2020

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PubMed Search: Multiple pulmonary leiomyomatous hamartomas

Roseann Wu, M.D., M.P.H.
Page views in 2020: 718
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Cite this page: Wu R. Multiple pulmonary leiomyomatous hamartomas. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lungtumorleiomyomatoushamartomas.html. Accessed October 25th, 2021.
Definition / general
  • Proliferation of multiple smooth muscle nodules in the lung parenchyma
Essential features
  • Multiple, small, unencapsulated nodules of smooth muscle in fascicles
  • Extremely rare, with controversial relationship to benign metastasizing leiomyoma or leiomyosarcoma
Terminology
  • Controversial whether are true hamartomas or represent metastasizing leiomyoma or leiomyosarcoma
Epidemiology
  • Extremely rare, almost always asymptomatic middle aged women
Sites
  • Throughout lung parenchyma, occasionally bronchovascular distribution
Etiology
  • Possible origin from contractile system of the lung acini (contractile interstitial cell)
Clinical features
  • Usually incidental
Diagnosis
  • Biopsy of nodules
Radiology description
  • Xray: abnormal nodular shadows
  • CT: multiple small pulmonary nodules
Prognostic factors
Case reports
Treatment
  • Surveillance, enucleation or surgical removal
Gross description
  • 2 - 15 mm white, firm, solid, well demarcated nodules
Microscopic (histologic) description
  • Excessive smooth muscle bundles in fascicles, not associated with tumor
  • Spindle cells with eosinophilic, fibrillary cytoplasm and blunt, elongated nuclei
  • Scattered glands and duct-like spaces may be seen
  • No mitoses, no nuclear atypia
Positive stains
Negative stains
Differential diagnosis
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