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Park, Lim, Jang, Kim, Jee, Cho, Park, Lee, and Mo: Benign Metastasizing Pulmonary Leiomyoma with Hemoptysis
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 60(1): 92-96.

Published online: 31 January 2006

DOI: https://doi.org/10.4046/trd.2006.60.1.92

Benign Metastasizing Pulmonary Leiomyoma with Hemoptysis

So Young Park, M.D., Eun-Ju Lim, M.D., Ji-Sun Jang, M.D., Chang-Hwan Kim, M.D., Hyun Keun Jee, M.D.1, Sung Jin Cho, M.D.2, Yong Bum Park, M.D., Jae Young Lee, M.D., Eun Kyung Mo, M.D.

Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon, Korea.

1Department of Thoracic surgery, College of Medicine, Hallym University, Chuncheon, Korea.

2Department of Anatomical Pathology, College of Medicine, Hallym University, Chuncheon, Korea.

Address for correspondence: Yong Bum Park M.D., Department of Internal Medicine, Kangdong Sacred Heart Hospital, 445 Kildong Kangdong-Gu, Seoul, Korea. Phone: 82-2-2225-2754, Fax: 82-2-478-6925, bfspark@medimail.co.kr

Received 20 July 2005       Accepted 4 November 2005

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

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.

Keywords: Benign metastasizing pulmonary leiomyoma, Uterine leiomyoma, GnRH analogue

Figures and Tables

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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