Tuberc Respir Dis.  2009 Dec;67(6):551-555.

2 Cases of a Benign Pulmonary Metastasizing Leiomyoma

• Lee EJ
• Jeong HC
• Lee SY
• Kim JH
• Lee SY
• Shin C
• Shim JJ
• In KH
• Kang KH
• Yoo SH
• Lee SH
• Kim HK
• Oh YW

Abstract

A benign pulmonary metastasizing leiomyoma is a recognized clinical entity that has been infrequently reported in the medical literature. We report two cases of a benign pulmonary metastasizing leiomyoma. A 35-year-old woman who underwent myomectomy and a cesarean section approximately 6 years earlier visited our hospital for further evaluation of incidentally revealed multiple lung nodules. A diagnostic percutaneuous biopsy was performed. Finally she was diagnosed with a benign metastasizing leiomyoma. The patient then received LH-RH and has been followed up since. The other 44-year-old woman presented after an initial radiology evaluation revealed the presence of multiple, small-sized lung nodules. She underwent a right middle lung wedge resection to confirm the diagnosis. Finally she diagnosed with a benign metastasizing leiomyoma. The multiple lung nodules have been followed up closely.

Keyword

Benign Metastasizing Leiomyoma; Lung Nodules; Myomectomy; Hysterectomy

MeSH Terms

Adult
Biopsy
Cesarean Section
Female
Gonadotropin-Releasing Hormone
Humans
Hysterectomy
Leiomyoma
Lung
Pregnancy
Gonadotropin-Releasing Hormone

Figure

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  Figure 1 Chest radiograph shows multiple lung nodules.

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  Figure 2 Chest CT shows two round, well-defined and poorly enhanced nodules.

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  Figure 3 (A) Microscopic examination of a percutaneous needle biopsy specimen of the lung nodule shows intersecting bundles of spindle-shaped cells, which are strongly-positive for (B) smooth muscle actin immunohistochemical stain, and they highly express both (D) estrogen and (E) progesterone. However, the tumor cells are negative for (C) C-kit (CD 117) immunohistochemical stain (A, H&E stain, ×400).

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  Figure 4 Chest radiograph shows multiple, round lung nodules.

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  Figure 5 Chest CT reveals multiple nodules ranging in diameter from a few millimeters to 2 cm.

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  Figure 6 (A) The resected nodule is clearly demarcated from thesurrounding lung tissue. (B) It shows thetypical features of a leiomyoma with no findings suggestive of malignant potential such as coagulative necrosis, increased mitotic activity or significant atypia. (C) The low cuboidal metaplastic bronchiolar epithelia are invaginated and entrapped between the fascicles of the smooth muscle (H&E stain, A, ×40, B, ×200, C, ×200).

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