Intranodal Leiomyoma in a Young Child: Report of a Rare Spindle Cell Lesion

Abstract

Primary spindle cell lesions of lymph nodes, with the exception of Kaposi's sarcoma, are rare. Intranodal palisaded myofibroblastoma has been described as a spindle cell tumor with prominent amianthoid fibers, intralesional hemorrhage, and intracellular or extracellular inclusions. Another spindle cell lesion, intranodal leiomyoma, has been reported only occasionally. We report the case of a 6-year-old boy with a mass in the neck without other systemic complaints. Excision biopsy of the lymph node revealed a spindle cell tumor with lymph nodal tissue at the periphery. The tumor showed features of smooth muscle differentiation with focally high mitotic index. The classical features of myofibroblastoma were not present. A final pathologic diagnosis of intranodal leiomyoma was rendered. The child has been free of recurrence in the follow-up period. Intranodal leiomyoma is a rare primary spindle cell lesion of the lymph nodes and should be considered in the differential diagnosis of the same.

Incidental Pelvic and Para-aortic Lymph Node Lymphangioleiomyomatosis Detected During Surgical Staging of Pelvic Cancer in Women Without Symptomatic Pulmonary Lymphangioleiomyomatosis or Tuberous Sclerosis Complex

“…Angiomyomatous hamartoma of lymph node may also contain a fascicular proliferation of myoid cells. [35][36][37][38][39][40] Examination of the tissue adjacent to the fascicular spindle cell proliferation and thorough examination of the rest of the lymph node, including deeper level sections, may reveal the classical nested and nodular architecture of LAM. Because all of the entities in this differential diagnosis are uncommon, immunohistochemistry to exclude LAM may be prudent.…”