Frequent estrogen and progesterone receptor immunoreactivity in renal angiomyolipomas from women with pulmonary lymphangioleiomyomatosis

Objective: To determine whether renal angiomyolipomas from women with pulmo nary lymphangioleiomyomatosis (LAM) express estrogen receptor (ER) and prog esterone receptor (PR). Design: Retrospective study of archival tissue. Patients: Twelve women with LAM and angiomyolipomas. Setting: Fos Chase Cancer Center. Interventions: ER and PR expression was s tudied using immunohistochemistry. The hormonal status of the patients at t he time of resection of the angiomyolipoma was determined. Results: Ten of the angiomyolipomas had ER immunoreactivity (83%), and all 12 had PR immunoreactivity (100%). The ER and PR positivity was in the smoo th muscle component of tl le angiomyolipomas only. For five women, pulmonar y LAM specimens were also available; two were ER positive (40%), and all fi ve were PR positive (100%). All four angiomyolipomas horn women receiving p rogesterone therapy were ER and PR positive. One tumor from a woman receivi ng tamoxifen was ER negative and strongly PR positive, One woman was pregna nt; her tumor was ER and PR positive, Conclusions: ER and PR expression is frequent in renal angiomyolipoma cells from women with LAM. PR was more consistently present than ER in angiomyol ipomas and in LAM. Our data suggest that angiomyolipoma growth could be aff ected by hormonal factors. if the growth of LAM -associated angiomyolipomas slows during hormonal therapy, there are two potential implications for LA M patients: first, angiomyolipoma size could serve as a measurable indicati on of response to hormonal therapy; and second, surgical removal of angiomy olipomas might be avoided in some cases.