The electron microscopic features of pulmonary leiom yomatous hamartoma, a very rare neoplasm, were studied. Characteristic smooth muscle cells containing microfilaments, dense bodies, plaques, pinocytotic vesicles, and basal lamina were present. Fibrosis was minimal, which supports the belief that this component is a secondary phenomena.Cancer 38:1199-1204, 1976.
ULTIPLE PULMONARY FIBROLEIOMYOMATOUSM hamartomas are extremely rare benign lung lesions seen in asymptomatic middle-aged female patients. Apparently only 10 cases have been documented in the literature. 2 -~8 -1 0 -1 2 Although Kaplan et a1.3 illustrated their case with a n electron micrograph, this lesion has not been extensively studied ultrastructurally.Recently we had the opportunity to study the eleventh example of this lesion, with a thorough ultrastructural examination.
CASE REPORTA 55-year-old black woman was hospitalized after a coin lesion of the right mid-zone lung had shown a gradual increase in size. Approximately 7 years previously, three coin lesions of the right lung were discovered on a routine chest-x-ray. She was followed closely, but had no complaints of dyspnea, hemoptysis, weight loss, fever, chills, or increase in size of the lesion on x-ray until the present time. A cough productive of a small amount of sputum was noted. A right supraclavicular node biopsy performed approximately 4 years previous to admission showed chronic lymphadenitis. Pertinent past medical history revealed a hysterectomy for leiomyoma approximately 15 years ago. The patient had been a diabetic controlled by diet for the past 5 years.O n admission the patient was in no distress, normotensive, afebrile, and well nourished. A systolic grade Il/VI murmur, heard best along the left sternal border and radiating to the apex and neck, was noted. This was felt to represent aortic stenosis. There was no evidence of left ventricular hypertrophy on EKG.Laboratory findings included: hemoglobin 12.5 g/ 100 ml, leukocyte count 7,00O/mm, platelet count 265,000/mm.3 A SMA 12 survey and urinalysis were within normal limits. Pulmonary ventilatory studies revealed a mild obstructive pulmonary abnormality with a slight reduction of the forced expiratory volume/ 1 second (FEV,) of 2.22 liters (76%) and a maximal mid-exploratory flow (MMEF) of 1.96 liters/ second. Arterial blood gases showed a hemoglobin saturation of 97%, pCO, of 34 mm Hg, pH of 7.43, and plasma HCO, of 22 mM/liter. Chest x-rays and tomograms showed a coin lesion in the right upper lobe which measured 2.2 cm, a coin lesion of the left upper lobe which measured 6 mm, and a coin lesion of the right mid-zone which measured 2.5 cm. No calcifications were seen. The lesions were felt to represent granulomata or, possibly, slowly growing pulmonary metastases (Fig. l).O n the fourth hospital day a right thoracotomy was performed with a wedge resection and subsegmental resection of the three coin lesions of the right lung; two in the upper lobe and one in the right middle lobe. A frozen-section diagnosis of multiple pulm...
