Abstract

Research Article

Uterine precursor lesions in patients with incidental nodal lymphangioleiomyomatosis: A report of 4 cases

Charles M Lombard*

Published: 14 December, 2020 | Volume 4 - Issue 1 | Pages: 001-004.

Uterine sections from 6 patients with incidental nodal lymphangioleiomyomatosis (LAM) were examined for LAM lesions by screening these sections with cathepsin K immunohistochemistry (IHC) stains. The hysterectomy specimens were all concurrent with the lymph node dissections in which the nodal LAM was discovered. In 4 of 6 patients microscopic lesions of pre-LAM were identified and confirmed by IHC staining for HMB-45 and beta-catenin. All lesions were grossly inapparent and also inapparent by routine hematoxylin and eosin stains. Three variants of pre-LAM lesions were identified. None of the pre-LAM lesions had an associated lymphatic proliferation. It is proposed that these pre-LAM lesions gave rise to the incidental nodal LAM lesions. Furthermore, it is suggested that the absence of an associated lymphatic proliferation associated with these lesions may be a factor in the attenuated potential for spread and the only rare association of these nodal lesions with pulmonary LAM.

Read Full Article HTML DOI: 10.29328/journal.apcr.1001016 Cite this Article Read Full Article PDF

Keywords:

Nodal lymphangioleiomyomatosis; Uterine precursor lesion; Pathogenesis; Pathology

References

  1. Schoolmeester JK, Park KJ. Incidental nodal lymphangioleiomyomatosis is not a harbinger of pulmonary lymphangioleiomyomatosis: a study of 19 cases with evaluation of diagnostic immunohistochemistry. Am J Surg Pathol. 2015; 39: 1404-1410. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26135558
  2. Rabban JT, Firetag B, Sangoi AR, Post MD, Zaloudek CJ. Incidental pelvic and para-aortic lymph node lymphangioleiomyomatosis detected during surgical staging of pelvic cancer in women without symptomatic pulmonary lymphangioleiomyomatosis or tuberous sclerosis complex. Am J Surg Pathol. 2015; 39: 1015-1025. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25786086
  3. Kuno I, Yoshida J, Shimizu H, Uehara T, Uno M, et al. Incidental lymphangioleiomyomatosis in the lymph nodes of gynecologic surgical specimens. Eur J Ob Gynec Reprod Biol. 2018; 231: 93-97. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30336310
  4. Hayashi T, Kumasaka T, Mitani K, Terao Y, Watanabe M, et al. Prevalence of uterine and adnexal involvement in pulmonary lymphangioleiomyomatosis: a clinicopathologic study of 10 patients. Am J Surg Pathol. 2011; 35: 1776-1785. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22020043
  5. Lombard CM. Microscopic precursor lesions of uterine lymphangioleiomyomatosis associated with incidental nodal lymphangioleiomyomatosis. A case report and discussion of pathogenesis. Hum Pathol Case Rep (in press).
  6. Flavin RJ, Cook J, Fiorentino M, Bailey D, Brown M, et al. Beta-Catenin is a useful adjunct immunohistochemical marker for the diagnosis of pulmonary lymphangioleiomyomatosis. Am J Clin Pathol. 2011; 135: 776-782. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21502434
  7. Kumasaka T, Seyama K, Mitani K, Sato T, Souma Sm et al. Lymphangiogenesis in lymphangioleiomyomatosis: its implication in the progression of lymphangioleiomyomatosis. Am J Surg Pathol. 2004; 28: 1007-1016. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15252306
  8. Gyure KA, Hart WR, Kennedy AW. Lymphangioleiomyomatosis of the uterus associated with tuberous sclerosis and malignant neoplasia of the female genital tract: a report of two cases. Int J Gynecol Pathol. 1995; 14: 344-351. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8598338v

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Figure 1

Figure 3

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More