title: Extrapulmonary lymphangioleiomyomatosis presented as the asymptomatic retroperitoneal tumours--two cases report.
abstract: Lymphangioleiomyomatosis [LAM] is a rare lung disease affecting women and characterized by abnormal smooth muscle cells (LAM cells) proliferation along lung and lymphatic channels. The frequent occurrence of extrapulmonary LAM [e-LAM] has been reported as abdomen pelvic lymph nodes involvement, angiomyolipomas, lymphangioleiomyomas or lymphangiomas in LAM patients. An extrapulmonary manifestation as the initial LAM presentation preceding pulmonary disorders and as asymptomatic extrapulmonary LAM lesions are unusual. We report two women presented with asymptomatic retroperitoneal cystic masses accidentally found on ultrasound examination. The tumours were surgically removed and diagnosed as: 1-malignant mesothelioma and 2-tymphangiomyoma. The microscopical sections were reviewed and re-diagnosed as e-LAM at advanced pulmonary LAM development. Mesotheliosis present in e-LAM morphology is unique and was misleading for malignancy diagnosis. The second case illustrates the hormone dependent growth of lymphangiomyoma and LAM development in young women. It is difficult to prove the presence of pulmonary LAM at the time of tumours excision but both cases demonstrate importance of appropriate LAM diagnosis and being aware of such diagnosis in cases presenting with extrapulmonary extension of the disease.
authors.affiliation: Department of Telepathology, National Institute of Tuberculosis and Lung Diseases, Warszawa. j.slodkowska@igichp.edu.pl
authors.forename: Janina
authors.initials: J
authors.lastname: Słodkowska
authors.forename: Jan
authors.initials: J
authors.lastname: Patera
authors.forename: Jan
authors.initials: J
authors.lastname: Breborowicz
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Jarzemska
authors.forename: Maria
authors.initials: M
authors.lastname: Korzeniewska-Kosela
authors.forename: Krystyna
authors.initials: K
authors.lastname: Siemiatkowska
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Radzikowska
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Przybylski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kozłowski
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology; D018192:Lymphangioleiomyomatosis / Q000175:diagnosis* / Q000473:pathology*; D008203:Lymphangiomyoma / Q000175:diagnosis / Q000473:pathology; D008654:Mesothelioma / Q000175:diagnosis / Q000473:pathology; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis* / Q000473:pathology*