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Weekly Chest CasesArchive of Old Cases

Case No : 847 Date 2014-01-20

  • Courtesy of Jiyeon Lim, Chang Min Park / Seoul National University Hospital
  • Age/Sex 46 / F
  • Chief ComplaintAbnormality on routine checkup
  • Figure 1
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Diagnosis With Brief Discussion

Diagnosis
Benign Metastasizing Leiomyoma
Radiologic Findings
On initial chest radiograph, multiple small nodular opacities were noted in both lung fields.Initial chest CT showed multiple small nodules in the bilateral lungs, and there was no evidence of calcification within the nodules.
Follow-up chest CT taken 13months later showed slightly increase in size of some of these nodules in the bilateral lungs. There was no evidence of mediastinal lymph node enlargement.
One month after the follow-up CT, the FDG PET was performed and showed no definite FDG uptakes of these nodules.


PHx> s/p TAH due to submucosal leiomyoma 11 months ago

Lung, percutaneous needle biopsy results: Consistent with leiomyoma (CD34: Negative, Desmin: Positive, Smooth muscle actin: Positive, S-100: Negative)
Brief Review
Pulmonary benign metastasizing leiomyoma from uterus is very rare and pathogenesis of this disease has not yet been elucidated. Most patients are pre-menopausal.

Sx: Asymptomatic (m/c)
Diagnosis: 1) history of uterine leiomyoma
2) Positive for SMA, Negative for S-100
3) Need for clinical correlation.
Radiologic feature;
multiple nodules in 87% of cases (70% bilateral nodules and 17% unilateral nodules)or as a solitary nodule in 13% of cases
Please refer to
Case 394, Case 413, Case 667,
References
1. Koh DM, Burn PR, King DM. Benign metastasizing leiomyoma with intracaval leiomyomatosis, Br J Radiol. 2000;73;435-437
2. Fu Y, Li H, Tian B. Pulmonary benign metastasizing leiomyoma: a case report and review of the literature. World J Surg Oncol. 2012; 10:268
Keywords
Lung, Benign tumor,

No. of Applicants : 73

▶ Correct Answer : 20/73,  27.4%
  • - Tokyo Metropolitan Police Hospital , Japan Akifumi Hagiwara
  • - Kyoto University , Japan Akihiko Sakata
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - SALMAN IBN ABDULAZIZ UNIVERSITY HOSPITAL , Saudi Arabia Elbagir Nasser
  • - humiic , Korea (South) Ju Won Lee
  • - Dong-A University Hospital , Korea (South) Ji-yeon Han
  • - IRSA La Rochelle , France Denis Chabassiere
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Seong Yun
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - SNUH , Korea (South) Eui Jin Hwang
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - CHU Poitiers , France CHAN paul
  • - Korea University Guro Hospital , Korea (South) Jeong Woo Kim
  • - IRSA LA ROCHELLE , France, Metropolitan BIGOT
  • - kanto Rosai Hp , Japan Takana Yamakawa
  • - James Paget Hospital , U.K , United Kingdom nabil mahmood
  • - Ishikawa Matto Central Hospital , Japan Manabu Akimoto
  • - C.B.H. Dpt of Imaging- " Clinica Mater Dei" Bari , Italy Carlo Florio
  • - CNUH , Korea (South) Kim Soo Hyun
  • - All India Institute of medical sciences , India Justin Moses
▶ Correct Answer as Differential Diagnosis : 13/73,  17.8%
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Nagasaki University Hospital, Department of Pathology , Japan TOMONORI TANAKA
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Teikyo University Mizonokuchi Hospital , Japan Noriko Kobayashi
  • - GHOL, Hopital de Nyon , Switzerland Benoit Rizk
  • - Teikyo University Mizonokuchi Hospital , Japan Kaoru Sumida
  • - Medicheck health care , Korea (South) Chae Lim
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - Private sector , Greece Vasilios Tzilas
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