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          "en" => "<p id="spara002" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">&#40;a&#8211;f&#41;&#58;</span> Pulmonary nodule transthoracic biopsy - BML lung lesions consist of well-circumscribed nodules ranging in size from few millimeters to several centimeters in diameter&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> These tumors are composed of well-differentiated proliferative smooth muscle cells that form intersecting fascicles&#44; without atypia&#44; necrosis or mitotic figures&#46; The figure shows a pulmonary nodule &#40;a - H&#38;E staining&#41; and immunohistochemical staining&#46; The nodule is positive for SMA &#40;Anti-Smooth Muscle Antibody &#8211; b&#41;&#46; The cells show positive immunoreactivity toward desmin &#40;figure e&#41; and estrogen receptors &#40;figure d&#41; and have a negative imuunireactivity toward TTF1 &#40;figure c&#41; and CD34 &#40;figure f&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0002" class="elsevierStylePara elsevierViewall">Incidental pulmonary nodules are a diagnostic challenge for both radiologists and pulmonologists&#46;</p><p id="para0003" class="elsevierStylePara elsevierViewall">We report a case of a 47-year-old female&#44; with invasive oral squamous cell carcinoma of the tongue&#44; that presented with multiple bilateral peri centimetric pulmonary nodules revealed on a Cervicothoracic Computed Tomography &#40;CT&#41; scan&#44; requested for tumor staging&#46; The patient underwent hemiglossectomy and was referred to our Pulmonary Oncology clinic&#46;</p><p id="para0004" class="elsevierStylePara elsevierViewall">Clinical evaluation revealed a one-month history of non-productive cough and dyspnea with moderate effort&#44; as well as an exposure to parakeets for about 3 months&#46; She was a non-smoker and denied hemoptysis&#44; recent weight loss&#44; fever&#44; or any other constitutional symptoms&#46; Bronchofibroscopy showed no signs of endobronchial malignancy and bronchial aspirate was amicrobial&#46; Transthoracic biopsy was also performed&#44; which showed a disappearance of dominant nodules&#44; only centrilobular micronodules remaining&#46; Initial diagnosis was of hypersensitivity pneumonitis secondary to aviary exposure and conservative treatment with clinical and imagological surveillance was decided on&#46;</p><p id="para0005" class="elsevierStylePara elsevierViewall">After 9 months&#44; an increase in the size of all the nodules was detected&#44; some now with cavitation &#40;<a class="elsevierStyleCrossRef" href="#fig0001">Fig&#46; 1</a> c&#41;&#46; A transthoracic biopsy was therefore proposed&#44; which revealed histologic findings consistent with a benign metastatic leiomyoma &#40;<a class="elsevierStyleCrossRef" href="#fig0002">Fig&#46; 2</a>&#41;&#46; Subsequently&#44; the patient underwent a total hysterectomy with bilateral adnexectomy&#44; later confirming the diagnosis of uterine leiomyomas&#46; Computer scan images requested 4 months after surgery revealed partial regression of the nodules&#46; The patient remains under follow-up and the lesions were stable at last reevaluation&#44; 2 years after surgery &#40;<a class="elsevierStyleCrossRef" href="#fig0002">Fig&#46; 2</a> c and d&#41;&#46;</p><elsevierMultimedia ident="fig0001"></elsevierMultimedia><elsevierMultimedia ident="fig0002"></elsevierMultimedia><p id="para0006" class="elsevierStylePara elsevierViewall">Benign metastatic leiomyoma &#40;BML&#41; is a rare entity of unknown prevalence&#59; a 2017 review reports 161 cases described in the literature between 1 January 1965 to 10 April 2016&#44; only 10 in women who have not undergone prior surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> The first reported case described a patient who died due to extensive pulmonary metastasis later identified as leiomyomas present in the uterus&#46;<a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a></p><p id="para0007" class="elsevierStylePara elsevierViewall">Benign metastatic leiomyoma usually affects women with a history of uterine leiomyomas&#44; metastasizing to extrauterine sites&#46; The most frequent sites of metastasis are the lung and lymph nodes&#44; with the most common presentation being multiple pulmonary nodules composed of smooth muscle cells&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> Benign metastatic leiomyomas have also been detected in the mediastinum&#44; retroperitoneum&#44; vascular channels&#44; bone&#44; heart&#44; skeletal muscle&#44; and soft tissues&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a></p><p id="para0008" class="elsevierStylePara elsevierViewall">The diagnosis usually occurs incidentally in a chest radiography&#44; or postmortem&#46; Clinical course is generally indolent and most patients are asymptomatic&#46; However&#44; some may present with cough&#44; wheezing&#44; dyspnea&#44; or chest pain&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a></p><p id="para0009" class="elsevierStylePara elsevierViewall">The mean age at time of diagnosis is 47 years old&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> BML is more frequent in women who have undergone previous myomectomies or hysterectomies&#44; one of the theories being the possibility of peritoneal seeding at the time of surgery&#44; with subsequent metastasis&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> This theory is not consensual&#44; because there are rare&#44; reported cases in which women did not have a history of uterine interventions&#46; The etiology of the disease remains unknown&#46;</p><p id="para0010" class="elsevierStylePara elsevierViewall">Imaging findings of BLM are nonspecific and overlap with other entities&#44; making the diagnosis by imaging alone almost impossible&#46; On thoracic CT&#44; BML typically presents as multiple bilateral well-defined non-calcified solid nodules of variable size&#44; without a predominant distribution pattern&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a> Unilateral or solitary nodules can occur but are less common&#46; Other rarely described features include associated interstitial lung disease&#44; a miliary pattern&#44; cystic lesions&#44; and cavitation&#46;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> Uptake on FDG-PET is usually weak or absent<a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> and there is no associated pleural effusion or mediastinal lymphadenopathy&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a></p><p id="para0011" class="elsevierStylePara elsevierViewall">Treatment is not standardized due to the rarity of the disease&#46; Lung tumors may revert after menopause and during or after pregnancy&#44; supporting a role for estrogen in BML pathophysiology&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> Surveillance&#44; oophorectomy or hormonal treatment with antiestrogenic therapy are options described in the literature&#46; Lung lesions usually remain stable&#44; with some cases of regression after treatment&#46;</p><p id="para0012" class="elsevierStylePara elsevierViewall">The presented case is relevant due to the rarity of the disease and the symptomatic presentation&#44; in a patient with a recent diagnosis of a head and neck cancer and no history of previous myomectomies or hysterectomies&#46; The differential diagnosis is broad and includes metastatic disease or a primary lung cancer&#44; and both infectious and non-infectious causes of granulomas &#40;tuberculosis&#44; granulomatosis with polyangiitis&#44; etc&#46;&#41;&#46; The recent bird exposure&#44; and the reduction of size of the nodules during follow-up&#44; added the possibility of a subacute hypersensitivity pneumonitis&#46; In this case&#44; the exposure to birds was detected after bronchoscopy&#44; so bronchoalveolar lavage had not been performed&#46; It was a challenging case and is an example of the importance of a multidisciplinary discussion&#46; In high-risk patients for metastatic lung disease&#44; it can be difficult to consider benign causes of multiple lung nodules&#46; Nonetheless&#44; radiologists must be familiarized with BML given that it is associated with a very specific demographic and can be easily included or excluded in a differential&#46;<a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> It&#39;s important to highlight the importance of a thorough clinical history and physical examination even in cases that may seem straightforward at first&#46;</p><span id="sec0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Ethical considerations</span><p id="para0013" class="elsevierStylePara elsevierViewall">Written informed consent was obtained from the patient for publication of this article&#46;</p></span></span>"
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Letter to the Editor
Benign metastasizing leiomyoma presenting as multiple pulmonary nodules: A radiological-pathological correlation
M. Condea,
Corresponding author
mconde@chtmad.min-saude.pt

Corresponding author at: Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, 5000-508, Vila Real, Portugal
, A.S. Costab, T. Gomesc
a Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
b Radiology Department, Hospital Prof. Doutor Fernando Fonseca, E.P.E, Portugal
c Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real Portugal
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          "en" => "<p id="spara002" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">&#40;a&#8211;f&#41;&#58;</span> Pulmonary nodule transthoracic biopsy - BML lung lesions consist of well-circumscribed nodules ranging in size from few millimeters to several centimeters in diameter&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> These tumors are composed of well-differentiated proliferative smooth muscle cells that form intersecting fascicles&#44; without atypia&#44; necrosis or mitotic figures&#46; The figure shows a pulmonary nodule &#40;a - H&#38;E staining&#41; and immunohistochemical staining&#46; The nodule is positive for SMA &#40;Anti-Smooth Muscle Antibody &#8211; b&#41;&#46; The cells show positive immunoreactivity toward desmin &#40;figure e&#41; and estrogen receptors &#40;figure d&#41; and have a negative imuunireactivity toward TTF1 &#40;figure c&#41; and CD34 &#40;figure f&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0002" class="elsevierStylePara elsevierViewall">Incidental pulmonary nodules are a diagnostic challenge for both radiologists and pulmonologists&#46;</p><p id="para0003" class="elsevierStylePara elsevierViewall">We report a case of a 47-year-old female&#44; with invasive oral squamous cell carcinoma of the tongue&#44; that presented with multiple bilateral peri centimetric pulmonary nodules revealed on a Cervicothoracic Computed Tomography &#40;CT&#41; scan&#44; requested for tumor staging&#46; The patient underwent hemiglossectomy and was referred to our Pulmonary Oncology clinic&#46;</p><p id="para0004" class="elsevierStylePara elsevierViewall">Clinical evaluation revealed a one-month history of non-productive cough and dyspnea with moderate effort&#44; as well as an exposure to parakeets for about 3 months&#46; She was a non-smoker and denied hemoptysis&#44; recent weight loss&#44; fever&#44; or any other constitutional symptoms&#46; Bronchofibroscopy showed no signs of endobronchial malignancy and bronchial aspirate was amicrobial&#46; Transthoracic biopsy was also performed&#44; which showed a disappearance of dominant nodules&#44; only centrilobular micronodules remaining&#46; Initial diagnosis was of hypersensitivity pneumonitis secondary to aviary exposure and conservative treatment with clinical and imagological surveillance was decided on&#46;</p><p id="para0005" class="elsevierStylePara elsevierViewall">After 9 months&#44; an increase in the size of all the nodules was detected&#44; some now with cavitation &#40;<a class="elsevierStyleCrossRef" href="#fig0001">Fig&#46; 1</a> c&#41;&#46; A transthoracic biopsy was therefore proposed&#44; which revealed histologic findings consistent with a benign metastatic leiomyoma &#40;<a class="elsevierStyleCrossRef" href="#fig0002">Fig&#46; 2</a>&#41;&#46; Subsequently&#44; the patient underwent a total hysterectomy with bilateral adnexectomy&#44; later confirming the diagnosis of uterine leiomyomas&#46; Computer scan images requested 4 months after surgery revealed partial regression of the nodules&#46; The patient remains under follow-up and the lesions were stable at last reevaluation&#44; 2 years after surgery &#40;<a class="elsevierStyleCrossRef" href="#fig0002">Fig&#46; 2</a> c and d&#41;&#46;</p><elsevierMultimedia ident="fig0001"></elsevierMultimedia><elsevierMultimedia ident="fig0002"></elsevierMultimedia><p id="para0006" class="elsevierStylePara elsevierViewall">Benign metastatic leiomyoma &#40;BML&#41; is a rare entity of unknown prevalence&#59; a 2017 review reports 161 cases described in the literature between 1 January 1965 to 10 April 2016&#44; only 10 in women who have not undergone prior surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> The first reported case described a patient who died due to extensive pulmonary metastasis later identified as leiomyomas present in the uterus&#46;<a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a></p><p id="para0007" class="elsevierStylePara elsevierViewall">Benign metastatic leiomyoma usually affects women with a history of uterine leiomyomas&#44; metastasizing to extrauterine sites&#46; The most frequent sites of metastasis are the lung and lymph nodes&#44; with the most common presentation being multiple pulmonary nodules composed of smooth muscle cells&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> Benign metastatic leiomyomas have also been detected in the mediastinum&#44; retroperitoneum&#44; vascular channels&#44; bone&#44; heart&#44; skeletal muscle&#44; and soft tissues&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a></p><p id="para0008" class="elsevierStylePara elsevierViewall">The diagnosis usually occurs incidentally in a chest radiography&#44; or postmortem&#46; Clinical course is generally indolent and most patients are asymptomatic&#46; However&#44; some may present with cough&#44; wheezing&#44; dyspnea&#44; or chest pain&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a></p><p id="para0009" class="elsevierStylePara elsevierViewall">The mean age at time of diagnosis is 47 years old&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> BML is more frequent in women who have undergone previous myomectomies or hysterectomies&#44; one of the theories being the possibility of peritoneal seeding at the time of surgery&#44; with subsequent metastasis&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> This theory is not consensual&#44; because there are rare&#44; reported cases in which women did not have a history of uterine interventions&#46; The etiology of the disease remains unknown&#46;</p><p id="para0010" class="elsevierStylePara elsevierViewall">Imaging findings of BLM are nonspecific and overlap with other entities&#44; making the diagnosis by imaging alone almost impossible&#46; On thoracic CT&#44; BML typically presents as multiple bilateral well-defined non-calcified solid nodules of variable size&#44; without a predominant distribution pattern&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a> Unilateral or solitary nodules can occur but are less common&#46; Other rarely described features include associated interstitial lung disease&#44; a miliary pattern&#44; cystic lesions&#44; and cavitation&#46;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> Uptake on FDG-PET is usually weak or absent<a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> and there is no associated pleural effusion or mediastinal lymphadenopathy&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a></p><p id="para0011" class="elsevierStylePara elsevierViewall">Treatment is not standardized due to the rarity of the disease&#46; Lung tumors may revert after menopause and during or after pregnancy&#44; supporting a role for estrogen in BML pathophysiology&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> Surveillance&#44; oophorectomy or hormonal treatment with antiestrogenic therapy are options described in the literature&#46; Lung lesions usually remain stable&#44; with some cases of regression after treatment&#46;</p><p id="para0012" class="elsevierStylePara elsevierViewall">The presented case is relevant due to the rarity of the disease and the symptomatic presentation&#44; in a patient with a recent diagnosis of a head and neck cancer and no history of previous myomectomies or hysterectomies&#46; The differential diagnosis is broad and includes metastatic disease or a primary lung cancer&#44; and both infectious and non-infectious causes of granulomas &#40;tuberculosis&#44; granulomatosis with polyangiitis&#44; etc&#46;&#41;&#46; The recent bird exposure&#44; and the reduction of size of the nodules during follow-up&#44; added the possibility of a subacute hypersensitivity pneumonitis&#46; In this case&#44; the exposure to birds was detected after bronchoscopy&#44; so bronchoalveolar lavage had not been performed&#46; It was a challenging case and is an example of the importance of a multidisciplinary discussion&#46; In high-risk patients for metastatic lung disease&#44; it can be difficult to consider benign causes of multiple lung nodules&#46; Nonetheless&#44; radiologists must be familiarized with BML given that it is associated with a very specific demographic and can be easily included or excluded in a differential&#46;<a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> It&#39;s important to highlight the importance of a thorough clinical history and physical examination even in cases that may seem straightforward at first&#46;</p><span id="sec0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Ethical considerations</span><p id="para0013" class="elsevierStylePara elsevierViewall">Written informed consent was obtained from the patient for publication of this article&#46;</p></span></span>"
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                        "paginaFinal" => "110"
                        "link" => array:1 [
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                            4 => "S&#46;Y&#46; Hur"
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                        "tituloSerie" => "World J Surg Onc"
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                        "fecha" => "2004"
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                        "paginaFinal" => "460"
                      ]
                    ]
                  ]
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                        "tituloSerie" => "Oncol Lett"
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                        "paginaFinal" => "1350"
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Article information
ISSN: 25310437
Original language: English
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