Primary bronchial leiomyosarcoma: a diagnostic challenge

Abstract Background Pulmonary bronchial leiomyosarcoma is an extremely rare malignant tumour of the lung originating from the mesenchymal tissue. The retroperitoneal region is the most common site of leiomyosarcoma. It exhibits a high degree of malignancy and a poor prognosis, thereby highlighting t...

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Main Authors: Dan Chen, Shuai Luo
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-024-03472-1
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author Dan Chen
Shuai Luo
author_facet Dan Chen
Shuai Luo
author_sort Dan Chen
collection DOAJ
description Abstract Background Pulmonary bronchial leiomyosarcoma is an extremely rare malignant tumour of the lung originating from the mesenchymal tissue. The retroperitoneal region is the most common site of leiomyosarcoma. It exhibits a high degree of malignancy and a poor prognosis, thereby highlighting the significance of early diagnosis of this disease. Case demonstration A 61-year-old male with a smoking history of 40 + years was admitted to the hospital due to cough, expectoration, and shortness of breath that extended for half a year, which aggravated for two months and was succeeded by intermittent bloody sputum for one month. Chest computed tomography (CT) revealed a mass in the upper lobe of the right lung, which was identified as a malignant tumour lesion involving the upper thoracic oesophagus. The boundaries of the mass with the trachea, brachiocephalic artery, and right brachiocephalic vein were unclear. Brush liquid-based cytology of the right middle lobe bronchus was performed, followed by histopathological biopsy. The pathological diagnosis was leiomyosarcoma in the middle lobe of the right lung. After the diagnosis, he underwent chemotherapy in another hospital, and the case was followed up for six months, during which no recurrence was noted. Conclusions Pulmonary and bronchial leiomyosarcomas often occur in young males with rapid progression and poor prognosis, but metastasis is rare. Surgical resection is the first-line treatment. We report a case of pulmonary bronchial leiomyosarcoma. The cytological, histological, immunohistochemical, and differential diagnoses were analysed to improve the understanding of the disease. Presently, there exist some challenges in diagnosing and treating pulmonary bronchial leiomyosarcoma. Early detection and treatment are important to improve prognosis.
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spelling doaj-art-3732b54229434bfc8faa5b4f9c57d5c02025-01-12T12:06:35ZengBMCBMC Pulmonary Medicine1471-24662025-01-012511610.1186/s12890-024-03472-1Primary bronchial leiomyosarcoma: a diagnostic challengeDan Chen0Shuai Luo1Department of Pathology, Beijing Jishuitan Hospital Guizhou HospitalDepartment of Pathology, Affiliated Hospital of Zunyi Medical UniversityAbstract Background Pulmonary bronchial leiomyosarcoma is an extremely rare malignant tumour of the lung originating from the mesenchymal tissue. The retroperitoneal region is the most common site of leiomyosarcoma. It exhibits a high degree of malignancy and a poor prognosis, thereby highlighting the significance of early diagnosis of this disease. Case demonstration A 61-year-old male with a smoking history of 40 + years was admitted to the hospital due to cough, expectoration, and shortness of breath that extended for half a year, which aggravated for two months and was succeeded by intermittent bloody sputum for one month. Chest computed tomography (CT) revealed a mass in the upper lobe of the right lung, which was identified as a malignant tumour lesion involving the upper thoracic oesophagus. The boundaries of the mass with the trachea, brachiocephalic artery, and right brachiocephalic vein were unclear. Brush liquid-based cytology of the right middle lobe bronchus was performed, followed by histopathological biopsy. The pathological diagnosis was leiomyosarcoma in the middle lobe of the right lung. After the diagnosis, he underwent chemotherapy in another hospital, and the case was followed up for six months, during which no recurrence was noted. Conclusions Pulmonary and bronchial leiomyosarcomas often occur in young males with rapid progression and poor prognosis, but metastasis is rare. Surgical resection is the first-line treatment. We report a case of pulmonary bronchial leiomyosarcoma. The cytological, histological, immunohistochemical, and differential diagnoses were analysed to improve the understanding of the disease. Presently, there exist some challenges in diagnosing and treating pulmonary bronchial leiomyosarcoma. Early detection and treatment are important to improve prognosis.https://doi.org/10.1186/s12890-024-03472-1BronchiLeiomyosarcomaCytologyHistologyDiagnosis
spellingShingle Dan Chen
Shuai Luo
Primary bronchial leiomyosarcoma: a diagnostic challenge
BMC Pulmonary Medicine
Bronchi
Leiomyosarcoma
Cytology
Histology
Diagnosis
title Primary bronchial leiomyosarcoma: a diagnostic challenge
title_full Primary bronchial leiomyosarcoma: a diagnostic challenge
title_fullStr Primary bronchial leiomyosarcoma: a diagnostic challenge
title_full_unstemmed Primary bronchial leiomyosarcoma: a diagnostic challenge
title_short Primary bronchial leiomyosarcoma: a diagnostic challenge
title_sort primary bronchial leiomyosarcoma a diagnostic challenge
topic Bronchi
Leiomyosarcoma
Cytology
Histology
Diagnosis
url https://doi.org/10.1186/s12890-024-03472-1
work_keys_str_mv AT danchen primarybronchialleiomyosarcomaadiagnosticchallenge
AT shuailuo primarybronchialleiomyosarcomaadiagnosticchallenge