{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T14:02:48Z","timestamp":1789912968188,"version":"4.0.1"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low-grade fibromyxoid sarcoma (LGFMS) is an uncommon malignant fibroblastic neoplasm characterized by deceptively bland histology and risk of late recurrence and metastasis. Primary pulmonary LGFMS is rare, with fewer than a dozen reported patients. Because the lung is also the most frequent metastatic site for soft-tissue LGFMS, distinguishing a primary pulmonary tumor from metastatic disease requires careful clinicopathologic correlation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Presentation<\/jats:title>\n                    <jats:p>We report a 70-year-old woman with a slowly enlarging right lower lobe pulmonary mass on imaging during a 2-year interval. A computed tomography (CT)-guided biopsy revealed a spindle cell neoplasm with a nonspecific immunoprofile, necessitating external consultation. Immunohistochemical studies were negative for epithelial, melanocytic, mesothelial, smooth muscle, and solitary fibrous tumor markers. Diffuse MUC4 expression supported the diagnosis of LGFMS. A comprehensive metastatic survey revealed no evidence of an alternative primary soft-tissue tumor, supporting designation of the lesion as a primary pulmonary LGFMS. The patient underwent right lower lobectomy, which showed a well-circumscribed, low-grade spindle cell neoplasm with negative margins and no lymph node involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Primary pulmonary LGFMS is a rare diagnostic entity that requires integration of morphology, immunohistochemistry, occasionally molecular testing, and thorough metastatic evaluation. Diffuse MUC4 expression remains a critical diagnostic marker. Although LGFMS is considered a low-grade sarcoma, its potential for late recurrence and metastasis necessitates long-term clinical surveillance. This patient adds to the limited literature on primary pulmonary LGFMS and highlights key diagnostic considerations for pathologists evaluating spindle cell tumors of the lung.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10668969261474893","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:42:19Z","timestamp":1789738939000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary Pulmonary Low-Grade Fibromyxoid Sarcoma in a 70-Year-Old Woman: A Diagnostic Challenge in Thoracic Spindle Cell Pathology"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3862-1336","authenticated-orcid":false,"given":"Nathan","family":"Do","sequence":"first","affiliation":[{"name":"University of Kansas Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daffolyn Rachael Fels","family":"Elliott","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Meyer","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6158-4861","authenticated-orcid":false,"given":"Ameer","family":"Hamza","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"issue":"10","key":"e_1_3_2_2_2","first-page":"839","article-title":"Low-grade fibromyxoid sarcoma","volume":"11","author":"Evans HL.","year":"1987","unstructured":"Evans HL. 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