PMC6136481_01
A midline lesion involving the dorsal surface of the patient's tongue.
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On examination, a 1.5 cm diameter exophytic midline tongue lesion (Figure 1) was noted.
Lingual leiomyomatous hamartoma as seen on magnetic resonance imaging.
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A magnetic resonance image (MRI) of his tongue was obtained (Figure 2).
(a) Section of the hamartoma showing fascicles of smooth muscles, fat, and salivary glands, with normal covering epithelium (haematoxylin and eosin, original magnification x10). (b) Section of the hamartoma showing blood vessels, fascicles of smooth muscles, fat, and salivary glands (haematoxylin and eosin, original magnification x200). (c) High-power section of the hamartoma showing fascicles of smooth muscles and fat. (haematoxylin and eosin, original magnification x400).
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In this specimen, microscopy revealed circumscribed nodules covered by stratified squamous epithelium, and interlacing cords of eosinophilic spindle-shaped cells consistent with the smooth muscle within the lamina propria (Figures 3(a)-3(c)).
Immunohistochemical findings of a section of the hamartoma showing fascicles of smooth muscles with smooth-muscle actin immunoreactivity (original magnification x100).
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Immunostaining for alpha-smooth-muscle actin demonstrated large concentrations of smooth-muscle bundles; however, S-100 was found only in peripheral nerve bundles intermingled with smooth-muscle fibers (Figures 4 and 5).
Immunohistochemical findings of a section of the hamartoma showing low S100 immunoreactivity (original magnification x100).
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Immunostaining for alpha-smooth-muscle actin demonstrated large concentrations of smooth-muscle bundles; however, S-100 was found only in peripheral nerve bundles intermingled with smooth-muscle fibers (Figures 4 and 5).