Virchows Archiv A

, Volume 394, Issue 1–2, pp 133–141 | Cite as

Multiple pulmonary (hamartomatous?) leiomyomas

Light and electron microscopic study
  • A. Burkhardt
  • H. F. Otto
  • E. Kaukel
Original Articles

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.

Key words

Pulmonary benign tumors Leiomyoma Hamartoma 

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.

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Copyright information

© Springer-Verlag 1981

Authors and Affiliations

  • A. Burkhardt
    • 1
  • H. F. Otto
    • 1
  • E. Kaukel
    • 2
  1. 1.Institute of PathologyUniversity of HamburgFederal Republic of Germany
  2. 2.Department of Internal MedicineUniversity of HamburgHamburg 20Federal Republic of Germany

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