An autopsy case of pulmonary artery leiomyosarcoma.
A case of pulmonary artery leiomyosarcoma in a 37 year old Japanese man is reported. The patient complained of chest pain and hemosputum. CT scan and angiography revealed that a tumor arose from the right main branch of the pulmonary artery. The surgical specimen was interpreted as an undifferentiated sarcoma at this time. The tumor recurred 6 months after the resection, and he died of right-sided heart failure. At autopsy, the pulmonary artery truncus was distended by the tumor, which protruded into the lumen. The tumor was composed of pleomorphic cells, giant cells and spindle-shaped cells. Many of the tumor cells were immunohistochemically positive for alpha-smooth muscle actin and vimentin. Electron microscopy revealed microfilaments with dense bodies in the cytoplasm and a discontinuous basement membrane around the cells. Although adenocarcinoma was also observed in the colon, the authors conclude that the present tumor is not a metastasis but a primary leiomyosarcoma arising from the pulmonary artery. Imaging techniques were very useful for differentiating sarcoma from thrombus in this site, and immunohistochemical demonstration for alpha-smooth muscle actin was necessary for making a histological diagnosis of leiomyosarcoma.
Nakazawa
K
K
Department of Pathology, Shinshu University School of Medicine, Matsumoto, Japan.
Itoh
N
N
Shigematsu
H
H
Kanbayasi
T
T
D000199:Actins / Q000032:analysis; D000328:Adult; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007890:Leiomyosarcoma / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D000199:Actins