Skip to main content
SpringerLink
Log in

Multiple pulmonary (hamartomatous?) leiomyomas

Light and electron microscopic study

  • Original Articles
  • Published:
Virchows Archiv A Aims and scope Submit manuscript

Summary

The light and electron microscopical features of the lung tumors in a case of multiple pulmonary leiomyomas are described. The differential diagnosis of leiomyomatous tumors of the lung is discussed. They have to be differentiated from lymphangio-leiomyomatosis of the lungs. In the literature, multiple pulmonary leiomyomas are generally considered to be metastases from low grade uterine leiomyosarcoma or to be hamartomatous lung tumors. This is suggested by the glandular structures both within the tumor and on the surface. However, our ultrastructural observations showed these epithelia to have features of granular pneumocytes (type II), in particular they contain lamellar bodies and posess microvilli on their surface. Their formation is considered to be a secondary reaction of alveolar lining cells to tumor growth. A possible origin of multiple pulmonary leiomyomas from the contractile system of the lung acini (contractile interstitial cells) is discussed.

Zusammenfassung

Die licht- und elektronenmikroskopischen Befunde an den Lungentumoren eines Falles mit multiplen pulmonalen Leiomyomen werden beschrieben. Die Differential-Diagnose der leiomyomatösen Lungentumoren und besonders die Abgrenzung von der pulmonalen Lymphangiomyomatose wird besprochen. Multiple pulmonale Leiomyome werden in der Literatur als Metastasen von “low grade” uterinen Leiomyomen oder aber als Hamartome der Lunge betrachtet. Letztere Annahme beruht auf der Tatsache, daß auf der Oberfläche der Tumoren und in ihrem Inneren sich kubisches, drüsenartiges Epithel befindet. Dieses weist jedoch nach unseren Beobachtungen Merkmale der granulären Pneumocyten (Typ II) auf, insbesondere lamelläre Körper im Zytoplasma und Microvilli an der Oberfläche. Die Ausbildung dieser epithelialen Bedeckung wird deshalb als Reaktion des Alveolarepithels auf das Tumorwachstum aufgefaßt. Als mögliches Muttergewebe der multiplen pulmonalen Leiomyome wird das kontraktile System der Lungenacini (kontraktile interstitielle Zellen) diskutiert.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Albrecht FW (1907) Ueber Hamartome Verh Dtsch Path Ges 7:153–157

    Google Scholar 

  • Ariel IM, Trinidad S (1966) Pulmonary metastases from a uterine “leiomyoma”. Report of a case: evaluation of differential diagnosis and treatment policies. Am J Obstet Gynecol 94:110–116

    Google Scholar 

  • Baltisberger W (1921) Über die glatte Muskulatur der menschlichen Lunge. Z Anat Entw Gesch 61:249–282

    Google Scholar 

  • Barthel E, Eckert H (1971) Fibroleiomyom und Tuberkulom in einem Lungenlappen. Z Erkr Atmungsorgane 135:5–9

    Google Scholar 

  • Basset F, Soler P, Marsac J, Corrin B (1976) Pulmonary lymphangiomyomatosis. Three new cases studied with electron microcopy. Cancer 38:2357–2366

    Google Scholar 

  • Bateson EM (1973) So-called hamartoma of the lung — a true neoplasm of fibrous connective tissue of the bronchi. Cancer 31:1458–1469

    Google Scholar 

  • Brandt M (1952) Über Angiomatose der Lungen mit Wabenstruktur. Virchows Archiv 321:585–598

    Google Scholar 

  • Burkhardt A, Gebbers JO, Höltje WJ (1977) Die Bleomycin-Lunge. Systematische pathologisch-anatomische Untersuchungen an 15 Fällen. Dtsch Med Wochensch 102:281–289

    Google Scholar 

  • Carpinisan C, Coman C, Cubolteanu FI (1968) Contributions a l'étude du léiomyome pulmonaire. J Franc Med Chir Thorax 22:589–601

    Google Scholar 

  • Collet AJ, Des Biens G (1974) Fine structure of myogenesis and elastogenesis in the developing rat lung. Anat Rec 179:343–360

    Google Scholar 

  • Corrin B, Liebow AA, Friedman PJ (1975) Pulmonary lymphangiomatosis. Am J Pathol 79:348–368

    Google Scholar 

  • Corrssen G (1963) Changing concepts of the mechanism of pulmonary atelectasis. J Am Med Ass 183:314–317

    Google Scholar 

  • Dempster AG (1969) Adenomatoid hamartoma of the lung in a neonate. J Clin Pathol 22:401–406

    Google Scholar 

  • Enterline HT, Roberts B (1955) Lymphangiopericytoma — Case report of a previously undescribed tumor type. Cancer 8:582–587

    Google Scholar 

  • Gebbers JO, Seifert G, Riesner K (1977) Die fibrosierende Alveolitis. Ein Beitrag zur Ultrastruktur und Pathogenese interstitieller Lungenerkrankungen. Röntgen-Bl 30:539–550

    Google Scholar 

  • Guccion JG, Rosen SH (1972) Bronchopulmonary leiomyosarcoma and fibrosarcoma. A study of 32 cases and review of the literature. Cancer 30:836–847

    Google Scholar 

  • Heppleston AG (1956) The pathology of honeycomb lung. Thorax 11:77–93

    Google Scholar 

  • Horstmann JP, Pietra GG, Harman JA, Cole NG, Grinspan S (1972) Spontaneous regression of pulmonary leiomyomas during pregnancy. Cancer 39:314–321

    Google Scholar 

  • Inberg MV, Sutinen S, Tala E (1969) Leiomyoma of the lung and intercostal space. Report of four cases. Scand J Thorac Carciovasc Surg 3:52–58

    Google Scholar 

  • Inglis K (1960) The nature and origin of smooth-muscle-like neoplastic tissue in the lungs and corresponding lymph nodes in a case of so-called “honeycomb lungs”. Arch De Vecchi Anat Patol 31:179–209

    Google Scholar 

  • Joliat G, Stalder H, Kapanci Y (1973) Lymphangiomyomatosis: a clinico-anatomical entity. Cancer 31:455–461

    Google Scholar 

  • Kane PB, Lane BP, Cordice JWV, Greenberg GM (1978) Ultrastructure of the proliferating cells in pulmonary lymphangiomyomatosis. Arch Pathol Lab Med 102:618–622

    Google Scholar 

  • Kapanci Y, Mo Costabella P, Cerutti P, Assimacopoulos A (1979) Distribution and function of cytoskeletal proteins in lung cells with particular reference to “contractile interstitial cells”. Methods Arch Exp Pathol 9:147–168

    Google Scholar 

  • Kaplan C, Katoh A, Shamoto M, Rogow E, Scott JH, Cushing W, Cooper J (1973) Multiple leiomyomas of the lung: benign or malignant? Am Rev Respir Dis 108:656–659

    Google Scholar 

  • Keers RY, Smith FA (1960) A case of multiple pulmonary “ hamartomata” of unusual type. Br J Dis Chest 54:349–352

    Google Scholar 

  • Piccaluga A, Capelli A (1967) Metastasizing fibroleiomyomatosis of the uterus. A morphologic, histochemical and histomechanical study. Arch Ital Anat Ist Patol 41:99–164

    Google Scholar 

  • Pocock E, Craig JR, Bullock WK (1976) Metastatic uterine leiomyomata. A case report. Cancer 38:2096–2100

    Google Scholar 

  • Roenspies U, Morin D, Gloor E, von Hochstetter AR, Saegesser F, Senning A (1978) Bronchopulmonale Hamartome, Chondrome, Fibrome und Myxome. Schweiz Med Wschr 108:332–339

    Google Scholar 

  • Silverman JF, Kay S (1976) Multiple pulmonary leiomyomatous hamartomas: report of a case with ultrastructure examination. Cancer 38:1199–1204

    Google Scholar 

  • Spencer H (1977) Pathology of the lung. 3rd edition. Pergamon Press; Oxford, New York, Toronto, Syndney, Paris, Frankfurt

    Google Scholar 

  • Steiner PE (1939) Metastasizing fibroleiomyoma of the uterus. Report of a case and review of the literature. Am J Pathol 15:89–109

    Google Scholar 

  • Stone FJ, Churg AM (1977) The ultrastructure of pulmonary hamartoma. Cancer 39:1064–1070

    Google Scholar 

  • Sweet RS (1969) Pulmonary leiomyoma. Am J Roentgen 107:823–826

    Google Scholar 

  • Vadas G, Pare JAP, Thurlbeck WM (1967) Pulmonary and lymph node myomatosis: review of the literature and report of a case. Can Med Assoc J 96:420–424

    Google Scholar 

  • Vázquez JJ, Fernandez-Cuervo L, Fidalgo B (1976) Lymphangiomyomatosis: morphogenetic study and ultrastructural confirmation of the histogeneses of the lung lesion. Cancer 37:2321–2328

    Google Scholar 

  • Wang NS, Seemayer ThA, Ahmed MN, Morin J (1974) Pulmonary leiomyosarcoma associated with an arteriovenous fistula. Arch Pathol 98:100–105

    Google Scholar 

  • Wuketich S (1967) Angioleiomyomatose der Lunge und der Lymphknoten. Verh Dtsch Ges Pathol 51:333–338

    Google Scholar 

Download references

Author information

Author notes

  1. A. Burkhardt

    Present address: Institute of Pathology, University of Berne, Freiburgstr. 30, CH-3010, Berne, Switzerland

Authors and Affiliations

  1. Institute of Pathology, University of Hamburg, Federal Republic of Germany

    A. Burkhardt & H. F. Otto

  2. Department of Internal Medicine, University of Hamburg, Martinistrasse 52, D-2000, Hamburg 20, Federal Republic of Germany

    E. Kaukel

Authors
  1. A. Burkhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. F. Otto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Kaukel
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Dedicated to Professor Dr. G. Seifert on the occasion of his 60th birthday

Rights and permissions

Reprints and permissions

About this article

Cite this article

Burkhardt, A., Otto, H.F. & Kaukel, E. Multiple pulmonary (hamartomatous?) leiomyomas. Virchows Archiv [Pathol Anat] 394, 133–141 (1981). https://doi.org/10.1007/BF00431671

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00431671

Key words

Search

Navigation