Tuberc Respir Dis.  2006 Jan;60(1):92-96.

Benign Metastasizing Pulmonary Leiomyoma with Hemoptysis

• Park SY
• Lim EJ
• Jang JS
• Kim CH
• Jee HK
• Cho SJ
• Park YB
• Lee JY
• Mo EK

Abstract

A benign metastasizing pulmonary leiomyoma(BMPL) is a rare disease that is usually detected years after a hysterectomy or myomectomy. Despite the benign pathological appearance, these tumors can metastasize and become clinically malignant. Recently, we experienced case of BMPL with hemoptysis. A 43-year-old woman, who had undergone a hysterectomy due to uterine leiomyoma 8 years ago, visited our department complaining of intermittent hemoptysis. A chest CT showed bilateral multiple nodular lesions. Video-associated thoracoscopy was performed. The resected small nodular lesion revealed the proliferation of spindle cells without mitosis or nuclear atypism. The lesions tested positive to the smooth muscle marker (actin) by immunohistochemical staining. Therefore, the multiple nodules were considered as benign metastasizing pulmonary leiomyoma from a uterine leiomyoma. GnRH analogue therapy was initiated. A chest CT showed that the size and number of pulmonary lesions did not change after 3 months, and the patient was symptom free.

Keyword

Benign metastasizing pulmonary leiomyoma; Uterine leiomyoma; GnRH analogue

MeSH Terms

Adult
Female
Gonadotropin-Releasing Hormone
Hemoptysis*
Humans
Hysterectomy
Leiomyoma*
Mitosis
Muscle, Smooth
Rare Diseases
Thoracoscopy
Tomography, X-Ray Computed
Gonadotropin-Releasing Hormone

Figure

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  Figure 1 CT scan reveals multiple nodular opacities on both lung fields.

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  Figure 2 A : On the lowest magnification view, a well-circumscribed round nodular solid mass is found at the peripheral lung parenchyme(H&E, ×10). B : On the high magnification view, the tumor demonstrates high cellular smooth muscle cells showing multiply fascicular arrangement. There is no evidence of atypical mitosis, necrosis or pleomorphism. (H&E, ×200). C : The immunohistochemical stain shows actin-positive smoothe muscle cells (×100). D : Sections of uterine leiomyoma from hystrectomy show lower cellular smooth muscle cells (H&E, ×100).

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