Immunoreactivity for Sex Steroid Hormone Receptors in Pulmonary Hamartomas

Abstract

Sex steroid hormone [ie, estrogen (ER), progesterone (PgR), and androgen (AR)] receptors have been identified previously in normal salivary glands and, more variably, in salivary gland and salivary gland-type tumors. No data are available, however, on their expression in pulmonary hamartoma, a benign biphasic tumor consisting of reactive epithelial cells and neoplastic fibromyxoid stroma, cartilage and fat, which shares some morphologic, immunophenotypic, and genotypic features to pleomorphic adenoma of major salivary glands. Thirty pulmonary hamartomas (15 in male patients and 15 in age-matched female patients), were evaluated for ER, PgR, and AR immunoreactivity, and also for mesenchymal, epithelial, and myoepithelial markers, in the fibromyxoid, epithelial, and chondroid components. ER immunoreactivity was encountered in 90% of hamartomas, PgRs in 90%, and ARs in 53% (P<0.001), but not in normal lung tissues. ARs were confined to males (P<0.001), with a marginal prevalence in the fibromyxoid component (P=0.067). PgRs and ERs were instead present in both sex, with the former being restricted to the fibromyxoid stromal component (P<0.001) and the latter preferentially located in epithelial cells (P=0.107). In most cases, fibromyxoid stroma and spindle cells surrounding the chondroid foci displayed simultaneous immunoreactivity for ERs, PgRs, and ARs, along with immunoreactivity for vimentin, S-100 protein, glial fibrillary acid protein, smooth muscle actin, and calponin but lack of staining for cytokeratins. This profile is consistent with an incomplete myoepithelial differentiation of the receptor-expressing mesenchymal cells. In conclusion, sex steroid hormone receptor expression is a nonrandom event in pulmonary hamartoma, and may be related to the development and growth of this tumor.

Unusual cystic hamartomatous lung lesion with clinical manifestation of subpleural bullae in a woman of reproductive age: A case report

“…Interestingly, chondroid hamartomas contain stromal cells immunohistochemically expressing ER, PgR, and smooth muscle markers; however, the stromal cells differed from the spindle cells of the present case in that the stromal cells were associated with fibromyxoid substances and were also positive for S100 and glial fibrillary acid protein. Among other rare cases of pulmonary hamartoma, a recent case report described a fibroleiomyomatous hamartoma containing smooth muscle marker‐positive spindle cells that were also positive for PgR but not ER.…”

“…Additionally, another case of fibroleiomyomatous hamartoma contained stromal cells that were negative for both receptors. Sex steroid hormone receptor‐positive stromal cells in chondroid hamartomas are thought to be influenced by the patients' sex and to be related to the development and growth of the mass; this may be true in the present case. During a 1‐year follow up, the patient's acquired lung lesion enlarged, with formation of numerous multiloculated spaces.…”

“…In the normal pulmonary parenchyma in our patient, scattered stromal cells were faintly positive for PgR but not for ER (data not shown). Pelosi et al . also pointed out that PgR‐positive stromal cells were rarely present in normal lung tissue.…”

“…Pulmonary hamartoma, the most common benign tumor of the lung, is characterized radiologically by a ‘coin’ lesion, i.e., a round or lobulated solid nodule, and constitutes about 8% of all ‘coin’ lesions . Typical histological features of pulmonary hamartoma include a mesenchymal fibromyxoid tissue with a variable amount of cartilage, fat, fibrous tissue, and smooth muscle associated with embedded airway epithelium . The inclusion of cartilaginous tissue is exclusive to pulmonary hamartoma; thus, pulmonary hamartoma is commonly called chondroid hamartoma.…”

Estrogen receptor overexpression in malignant minor salivary gland tumors of the sinonasal tract

“…The expression of sex hormone receptors in some tumors suggests a role for these receptors in tumor pathogenesis and therapy. Previous reports indicated the possible expression of estrogen receptor (ER) in salivary gland tumors and suggested that sex hormones could have a role in the management of salivary gland tumors because there is a well-established similarity of basic acinar and ductal structures between breast tissue and salivary glands, but the results were inconclusive or conflicting due to the small number of cases and variant assay technique 4 - 8 . The sex hormone estrogen plays an important role in controlling the expression of genes involved in a wide variety of biological and neoplastic processes.…”