Endometrial stromal sarcoma metastatic to the lung: A detailed analysis of 16 patients

Marie Christine Aubry, Jeffrey L. Myers, Thomas V. Colby, Kevin O. Leslie, Henry D. Tazelaar

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Pulmonary metastases of endometrial stromal sarcoma (ESS) are uncommon and can pose diagnostic problems. We reviewed lung specimens from 16 patients with metastatic ESS. Patients were 31-77 years of age at the time of lung biopsy. Uterine ESSs were diagnosed an average of 9,8 years before lung biopsy in 11 patients. Uterine ESSs were originally called smooth muscle tumors in three additional patients, Thirteen patients were evaluated for new pulmonary nodules, seven of whom were asymptomatic. Nodules were multiple in 14 and solitary in four, ranging from 1.0 to 8.0 cm in greatest dimension. One patient died of metastatic disease; 14 were alive and seven of these were without disease (mean follow-up 4.1 years). Diagnostic considerations in 12 consultation cases included ESS, sclerosing hemangioma, carcinoid tumor, lymphangioleiomyomatosis, endometriosis, hemangiopericytoma, and lymphoma. Tumors were well circumscribed and usually solid, composed of plump spindle cells arranged in short fascicles. Two tumors were predominantly cystic. Sex cord-like stromal differentiation was identified in three. Neoplastic cells stained for vimentin (93%), estrogen and progesterone receptor (100%), smooth muscle actin (57%), desmin (50%), and keratin (46%). Metastatic ESS should be included in the differential diagnosis of nonepithelial neoplasms in women.

Original languageEnglish (US)
Pages (from-to)440-449
Number of pages10
JournalAmerican Journal of Surgical Pathology
Volume26
Issue number4
DOIs
StatePublished - 2002

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Endometrial Stromal Sarcoma
Lung
Lymphangioleiomyomatosis
Smooth Muscle Tumor
Benign Fibrous Histiocytoma
Hemangiopericytoma
Biopsy
Neoplasms
Desmin
Carcinoid Tumor
Vimentin
Progesterone Receptors
Endometriosis
Keratins
Estrogen Receptors
Smooth Muscle
Actins
Lymphoma
Differential Diagnosis
Referral and Consultation

Keywords

  • Endometrial stromal sarcoma
  • Estrogen and progesterone receptors
  • Leiomyoma Lymphangioleiomyomatosis
  • Pulmonary metastasis

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Endometrial stromal sarcoma metastatic to the lung : A detailed analysis of 16 patients. / Aubry, Marie Christine; Myers, Jeffrey L.; Colby, Thomas V.; Leslie, Kevin O.; Tazelaar, Henry D.

In: American Journal of Surgical Pathology, Vol. 26, No. 4, 2002, p. 440-449.

Research output: Contribution to journalArticle

Aubry, Marie Christine ; Myers, Jeffrey L. ; Colby, Thomas V. ; Leslie, Kevin O. ; Tazelaar, Henry D. / Endometrial stromal sarcoma metastatic to the lung : A detailed analysis of 16 patients. In: American Journal of Surgical Pathology. 2002 ; Vol. 26, No. 4. pp. 440-449.
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