Benign pulmonary metastasizing leiomvomatosis: case report and a review of the literature

Abstract

The authors report here on a case of a nearly asymptomatic 51-year-old Korean woman who was found to have diffuse, multiple nodules of the lungs on a routine chest radiograph. She had undergone hysterectomy 16 years previously for uterine myoma. An open lung biopsy revealed tumor that was composed of interlacing bundles of spindle cells with cigar shaped nucleus and eosinophilic myofibrils in the cytoplasm; consistent with multiple leiomyomas. The stains for SMA, desmin, MSA and Ki-67 were positive and the stain for c-kit was negative. The other stains for estrogen and progesterone receptor were positive. During the open lung biopsy procedure, all the nodules were excised. We report here on an interesting case of benign metastasizing leiomyoma (BML) in 51-year-old patient. To the best of our knowledge, this case showed the longest period of clinical progression in Korea. This is also one of a few cases in which curative excision was successfully performed.

Figure 1

Initial chest radiograph shows two small nodular lesions (arrows) in left perihilar and retrocardiac areas.

Figure 2

Chest CT that was done 4 month later shows well-demarcated 0.7 cm sized two nodules (arrows) in the left upper lobe (Figure A) and left lower lobe (Figure B), and focal bronchopneumonia is seen in the right middle lobe.

Figure 3

Histologic findings of the nodules resected from the left lung. (A) Hematoxylin and Eosin stain (×100). (B) Immunohistochemical staining for smooth muscle actin was positive (×300). (C) Immunohistochemical staining for desmin was positive (×300).