Cystic pulmonary metastases of endometrial stromal sarcoma of the uterus, mimicking lymphangiomyomatosis: a case report with immunohistochemistry of HMB45

Pathol Int. 1997 Oct;47(10):725-9. doi: 10.1111/j.1440-1827.1997.tb04449.x.


A case of endometrial stromal sarcoma (ESS) showed cystic pulmonary metastases mimicking lymphangiomyomatosis (LAM). A 58-year-old female, who had undergone total hysterectomy for low-grade ESS 16 years previously, had repeated bouts of pneumothorax. Multiple thin-walled cysts in the peripheral lung were revealed by radiological examinations. In an open-lung biopsy specimen, cystic lesions were surrounded by layers of spindle-shaped cells of varying thickness that resembled LAM. However, in addition to subtle histologic differences from LAM, HMB45 (antimelanoma antibody) showed positive in LAM (n = 3), but was negative in ESS (n = 2) and the cystic lesions of this case. Using myogenic markers (desmin and alpha-smooth muscle actin), metastatic ESS could be immunohistochemically differentiated from mesenchymal cystic hamartoma (n = 1). HMB45 immunohistochemistry is useful in the differential diagnosis of cystic pulmonary lesions.

Publication types

  • Case Reports

MeSH terms

  • Actins / analysis
  • Antigens, Neoplasm / analysis
  • Biomarkers / analysis
  • Biopsy
  • Desmin / analysis
  • Diagnosis, Differential
  • Endometrial Neoplasms / pathology
  • Female
  • Humans
  • Immunohistochemistry
  • Lung Neoplasms / chemistry*
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / secondary
  • Lymphangioleiomyomatosis / diagnostic imaging
  • Lymphangioleiomyomatosis / pathology*
  • Melanoma-Specific Antigens
  • Middle Aged
  • Neoplasm Proteins / analysis
  • Neoplasms, Cystic, Mucinous, and Serous / chemistry*
  • Neoplasms, Cystic, Mucinous, and Serous / diagnostic imaging
  • Neoplasms, Cystic, Mucinous, and Serous / secondary
  • Sarcoma / chemistry*
  • Sarcoma / diagnostic imaging
  • Sarcoma / secondary
  • Tomography, X-Ray Computed


  • Actins
  • Antigens, Neoplasm
  • Biomarkers
  • Desmin
  • Melanoma-Specific Antigens
  • Neoplasm Proteins