Author:
Shibayama Takahiro,Satomi Kaishi,Tanaka Ryota,Yoshida Akihiko,Nagahama Kiyotaka,Hayashi Akimasa,Hibiya Takashi,Suda Kazuharu,Fujiwara Masachika,Shibahara Junji
Abstract
Abstract
Background
Pulmonary inflammatory leiomyosarcoma (PILMS) is a rare type of myogenic tumor with prominent lymphohistiocytic infiltration. Despite their histological similarities, PILMS is immunohistochemically and genetically distinct from soft tissue inflammatory leiomyosarcoma, and its clinicopathological picture including DNA methylome data remains still unknown.
Case presentation
Here we present a case of PILMS in an 18-year-old male who underwent lobectomy. As reported previously, the current case demonstrated spindle myoid cell proliferation with smooth muscle differentiation within a prominent lymphohistiocytic infiltration and a diploid genome with a MUC3A gene alteration. DNA methylation analysis predicted this case to be an “inflammatory myofibroblastic tumor” (IMT) according to the Deutsches Krebsforschungszentrum (DKFZ) classifier. The data was analyzed by t-distributed stochastic neighbor embedding, which plotted the case tumor in the vicinity of IMT, however, there were no IMT histological features. These discordant results could be due to background non-neoplastic inflammatory cells.
Conclusions
As the DNA methylation classification of PILMS might be a potential diagnostic pitfall, an integrative histological and genetic approach is required for its accurate diagnosis.
Funder
Grants-in-aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science, and Technology
Research Grants from Bristol Myers Squibb K.K
Publisher
Springer Science and Business Media LLC
Subject
Pulmonary and Respiratory Medicine