Wikipedia

Multifocal micronodular pneumocyte hyperplasia

Multifocal micronodular pneumocyte hyperplasia (MMPH) is a subtype of pneumocytic hyperplasia (hyperplasia of pneumocytes lining pulmonary alveoli).[1][2][3][4][5]

Micrograph showing multifocal micronodular pneumocyte hyperplasia. H&E stain.

Several synonymous terms have been done for this entity: adenomatoid proliferation of alveolar epithelium, papillary alveolar hamartoma, multifocal alveolar hyperplasia, multinodular pneumocyte hyperplasia.

These multifocal lesions are observed in tuberous sclerosis,[6][7] and can be associated with lymphangioleiomyomatosis[8] and perivascular epithelioid cell tumour (PEComa or clear cell "sugar tumor")).[9]

It can be diagnosed through lung biopsy using thoracoscopy.[10]

Microscopy

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  • Well-demarcated, nodular lesions ranging 2–5 mm in pulmonary parenchyma.
  • Type II pneumocytes without nuclear atypia lined thickened alveolar septa and proliferated papillary structures.
  • Enlarged cuboidal cells lining mildly thickened alveolar septa.[11]
  • Enlarged cuboidal cells have abundant, eosinophilic cytoplasm and large, round nuclei.[12]
  • Papillary pattern with irregular margin and lymphocyte infiltration in the stroma.[13]
  • No proliferation of immature smooth muscle cells suggestive of lymphangioleiomyomatosis.

See also

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References

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  1. ^ Muir, T. E.; Leslie, K. O.; Popper, H; Kitaichi, M; Gagné, E; Emelin, J. K.; Vinters, H. V.; Colby, T. V. (1998). "Micronodular pneumocyte hyperplasia". The American Journal of Surgical Pathology. 22 (4): 465–72. doi:10.1097/00000478-199804000-00012. PMID 9537475.465-72&rft.date=1998&rft_id=info:doi/10.1097/00000478-199804000-00012&rft_id=info:pmid/9537475&rft.aulast=Muir&rft.aufirst=T. E.&rft.au=Leslie, K. O.&rft.au=Popper, H&rft.au=Kitaichi, M&rft.au=Gagné, E&rft.au=Emelin, J. K.&rft.au=Vinters, H. V.&rft.au=Colby, T. V.&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  2. ^ Ishii, M; Asano, K; Kamiishi, N; Hayashi, Y; Arai, D; Haraguchi, M; Sugiura, H; Naoki, K; Tasaka, S; Soejima, K; Sayama, K; Betsuyaku, T (2012). "Tuberous sclerosis diagnosed by incidental computed tomography findings of multifocal micronodular pneumocyte hyperplasia: A case report". Journal of Medical Case Reports. 6 (1): 352. doi:10.1186/1752-1947-6-352. PMC 3512476. PMID 23072249.
  3. ^ Miravet Sorribes, L; Mancheño Franch, N; Batalla Bautista, L (2013). "Multifocal micronodular pneumocyte hyperplasia in a patient with tuberous sclerosis". Archivos de Bronconeumología. 49 (1): 36–7. doi:10.1016/j.arbres.2012.06.006. PMID 22884294.36-7&rft.date=2013&rft_id=info:doi/10.1016/j.arbres.2012.06.006&rft_id=info:pmid/22884294&rft.aulast=Miravet Sorribes&rft.aufirst=L&rft.au=Mancheño Franch, N&rft.au=Batalla Bautista, L&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  4. ^ Shintani, Y; Ohta, M; Iwasaki, T; Ikeda, N; Tomita, E; Nagano, T; Kawahara, K (2010). "A case of micronodular pneumocyte hyperplasia diagnosed through surgical resection". Annals of Thoracic and Cardiovascular Surgery. 16 (1): 45–7. PMID 20190710.45-7&rft.date=2010&rft_id=info:pmid/20190710&rft.aulast=Shintani&rft.aufirst=Y&rft.au=Ohta, M&rft.au=Iwasaki, T&rft.au=Ikeda, N&rft.au=Tomita, E&rft.au=Nagano, T&rft.au=Kawahara, K&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  5. ^ Kobashi, Y; Sugiu, T; Mouri, K; Irei, T; Nakata, M; Oka, M (2008). "Multifocal micronodular pneumocyte hyperplasia associated with tuberous sclerosis: Differentiation from multiple atypical adenomatous hyperplasia". Japanese Journal of Clinical Oncology. 38 (6): 451–4. doi:10.1093/jjco/hyn042. PMID 18535095.451-4&rft.date=2008&rft_id=info:doi/10.1093/jjco/hyn042&rft_id=info:pmid/18535095&rft.aulast=Kobashi&rft.aufirst=Y&rft.au=Sugiu, T&rft.au=Mouri, K&rft.au=Irei, T&rft.au=Nakata, M&rft.au=Oka, M&rft_id=https://doi.org/10.1093%2Fjjco%2Fhyn042&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  6. ^ Kamiya, H; Shinoda, K; Kobayashi, N; Kudo, K; Nomura, T; Morita, T; Fujii, T (2006). "Tuberous sclerosis complex complicated by pulmonary multinodular shadows". Internal Medicine (Tokyo, Japan). 45 (5): 275–8. doi:10.2169/internalmedicine.45.1136. PMID 16595993.275-8&rft.date=2006&rft_id=info:doi/10.2169/internalmedicine.45.1136&rft_id=info:pmid/16595993&rft.aulast=Kamiya&rft.aufirst=H&rft.au=Shinoda, K&rft.au=Kobayashi, N&rft.au=Kudo, K&rft.au=Nomura, T&rft.au=Morita, T&rft.au=Fujii, T&rft_id=https://doi.org/10.2169%2Finternalmedicine.45.1136&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  7. ^ Kobashi, Y; Yoshida, K; Miyashita, N; Niki, Y; Matsushima, T; Irei, T (2005). "Multifocal micronodular pneumocyte hyperplasia in a man with tuberous sclerosis". Internal Medicine (Tokyo, Japan). 44 (5): 462–6. doi:10.2169/internalmedicine.44.462. PMID 18632095.462-6&rft.date=2005&rft_id=info:doi/10.2169/internalmedicine.44.462&rft_id=info:pmid/18632095&rft.aulast=Kobashi&rft.aufirst=Y&rft.au=Yoshida, K&rft.au=Miyashita, N&rft.au=Niki, Y&rft.au=Matsushima, T&rft.au=Irei, T&rft_id=https://doi.org/10.2169%2Finternalmedicine.44.462&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  8. ^ Maruyama, H; Seyama, K; Sobajima, J; Kitamura, K; Sobajima, T; Fukuda, T; Hamada, K; Tsutsumi, M; Hino, O; Konishi, Y (2001). "Multifocal micronodular pneumocyte hyperplasia and lymphangioleiomyomatosis in tuberous sclerosis with a TSC2 gene". Modern Pathology. 14 (6): 609–14. doi:10.1038/modpathol.3880359. PMID 11406664.609-14&rft.date=2001&rft_id=info:doi/10.1038/modpathol.3880359&rft_id=info:pmid/11406664&rft.aulast=Maruyama&rft.aufirst=H&rft.au=Seyama, K&rft.au=Sobajima, J&rft.au=Kitamura, K&rft.au=Sobajima, T&rft.au=Fukuda, T&rft.au=Hamada, K&rft.au=Tsutsumi, M&rft.au=Hino, O&rft.au=Konishi, Y&rft_id=https://doi.org/10.1038%2Fmodpathol.3880359&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  9. ^ Flieder, D. B.; Travis, W. D. (1997). "Clear cell "sugar" tumor of the lung: Association with lymphangioleiomyomatosis and multifocal micronodular pneumocyte hyperplasia in a patient with tuberous sclerosis". The American Journal of Surgical Pathology. 21 (10): 1242–7. doi:10.1097/00000478-199710000-00017. PMID 9331299.1242-7&rft.date=1997&rft_id=info:doi/10.1097/00000478-199710000-00017&rft_id=info:pmid/9331299&rft.aulast=Flieder&rft.aufirst=D. B.&rft.au=Travis, W. D.&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  10. ^ Fujitaka, K; Isobe, T; Oguri, T; Yamasaki, M; Miyazaki, M; Kohno, N; Takeshima, Y; Inai, K (2002). "A case of micronodular pneumocyte hyperplasia diagnosed through lung biopsy using thoracoscopy". Respiration; International Review of Thoracic Diseases. 69 (3): 277–9. doi:10.1159/000063635. PMID 12097776. S2CID 38358651.277-9&rft.date=2002&rft_id=https://api.semanticscholar.org/CorpusID:38358651#id-name=S2CID&rft_id=info:pmid/12097776&rft_id=info:doi/10.1159/000063635&rft.aulast=Fujitaka&rft.aufirst=K&rft.au=Isobe, T&rft.au=Oguri, T&rft.au=Yamasaki, M&rft.au=Miyazaki, M&rft.au=Kohno, N&rft.au=Takeshima, Y&rft.au=Inai, K&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  11. ^ Suzuki, K; Seyama, K; Hayashi, T; Yamashiro, Y; Shiraishi, A; Kuwatsuru, R (2013). "Reversed halo sign in tuberous sclerosis complex". Case Reports in Radiology. 2013: 1–4. doi:10.1155/2013/428501. PMC 3789275. PMID 24186304.1-4&rft.date=2013&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789275#id-name=PMC&rft_id=info:pmid/24186304&rft_id=info:doi/10.1155/2013/428501&rft.aulast=Suzuki&rft.aufirst=K&rft.au=Seyama, K&rft.au=Hayashi, T&rft.au=Yamashiro, Y&rft.au=Shiraishi, A&rft.au=Kuwatsuru, R&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789275&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  12. ^ Suzuki, K; Seyama, K; Hayashi, T; Yamashiro, Y; Shiraishi, A; Kuwatsuru, R (2013). "Reversed halo sign in tuberous sclerosis complex". Case Reports in Radiology. 2013: 1–4. doi:10.1155/2013/428501. PMC 3789275. PMID 24186304.1-4&rft.date=2013&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789275#id-name=PMC&rft_id=info:pmid/24186304&rft_id=info:doi/10.1155/2013/428501&rft.aulast=Suzuki&rft.aufirst=K&rft.au=Seyama, K&rft.au=Hayashi, T&rft.au=Yamashiro, Y&rft.au=Shiraishi, A&rft.au=Kuwatsuru, R&rft_id=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789275&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
  13. ^ Maruyama, H; Seyama, K; Sobajima, J; Kitamura, K; Sobajima, T; Fukuda, T; Hamada, K; Tsutsumi, M; Hino, O; Konishi, Y (2001). "Multifocal micronodular pneumocyte hyperplasia and lymphangioleiomyomatosis in tuberous sclerosis with a TSC2 gene". Modern Pathology. 14 (6): 609–14. doi:10.1038/modpathol.3880359. PMID 11406664.609-14&rft.date=2001&rft_id=info:doi/10.1038/modpathol.3880359&rft_id=info:pmid/11406664&rft.aulast=Maruyama&rft.aufirst=H&rft.au=Seyama, K&rft.au=Sobajima, J&rft.au=Kitamura, K&rft.au=Sobajima, T&rft.au=Fukuda, T&rft.au=Hamada, K&rft.au=Tsutsumi, M&rft.au=Hino, O&rft.au=Konishi, Y&rft_id=https://doi.org/10.1038%2Fmodpathol.3880359&rfr_id=info:sid/en.wikipedia.org:Multifocal micronodular pneumocyte hyperplasia" class="Z3988">
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