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Lung tumor

Benign tumors

Benign metastasizing leiomyoma


Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 6 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Benign appearing leiomyoma in lung, clonally derived from benign-appearing uterine leiomyomas (Mod Pathol 2006;19:130)
● Rare, ~100 cases reported to date
● Usually women ages 36-64 years, mean 44 years, often with prior history of uterine leiomyomas
● Regress during pregnancy or after oophorectomy
● May represent a well differentiated leiomyosarcoma of low malignant potential, metastatic to lung
● Nodule on chest Xray, but usually only mild cough and shortness of breath or no symptoms
● Good prognosis

Case reports
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● 48 year old woman with incidental retroperitoneal mass and multiple lung nodules (Clin Exp Reprod Med 2011;38:174)
● 76 year old woman with bilateral pulmonary nodules (Arch Pathol Lab Med 2003;127:501)
● Presenting as cystic lung disease (Histopathology 2011;59:786)

Treatment
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● Hysterectomy, bilateral salpino-oophorectomy, long term hormonal therapy

Gross images
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Retroperitoneal and lung masses

Micro description
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● Well circumscribed, single or multiple nodules of smooth muscle, composed of elongated cells with abundant eosinophilic cytoplasm, oval nuclei, inconspicuous nucleoli
● Large, irregularly shaped thick walled vessels
● May contain cysts
● No atypia, no vascular invasion, no mitotic figures

Micro images
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Various images


Comparison with leiomyosarcoma

Cytogenetics description
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● Genetically distinct entity with consistent chromosomal aberrations (19q and 22q terminal deletion in all cases, Am J Surg Pathol 2007;31:737)

Differential diagnosis
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Hamartoma
Low grade leiomyosarcoma: miR-221 expression differentiates leiomyosarcoma from benign metastasizing leiomyoma, Diagn Mol Pathol 2008;17:145)

End of Lung tumor > Benign tumors > Benign metastasizing leiomyoma


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