Lung
Mesenchymal tumors
Leiomyoma
Author: Roseann I. Wu, M.D., M.P.H.
Last author update: 1 October 2015
Last staff update: 27 January 2023 (update in progress)
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: Leiomyoma [title] lung
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Pathophysiology | Etiology | Clinical features | Diagnosis | Radiology description | Prognostic factors | Case reports | Treatment | Clinical images | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosis | Additional referencesCite this page: Wu R. Leiomyoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lungtumorleiomyoma.html. Accessed March 22nd, 2023.
Definition / general
- Extremely rare benign tumor (< 100 cases reported)
- Associated with HIV+ children
- Must exclude uterine origin - see benign metastasizing leiomyoma
Terminology
- Primary leiomyoma of lung
Epidemiology
- Predominantly female, most commonly in 30s - 40s
- ~2% of benign lung tumors
Sites
- 33% endobronchial, 51% parenchymal, 16% tracheal (Lung India 2013;30:57)
Pathophysiology
- Solitary, benign
Etiology
- Arises from smooth muscle of bronchial tree or pulmonary vasculature
Clinical features
- Typically incidental and asymptomatic
- May present with chest pain, cough, fever, hemoptysis, shortness of breath, pneumonia due to obstruction
Diagnosis
- Biopsy or resection
Radiology description
- Round or oval, well defined borders
- Endobronchial lesions may show pneumonia or atelectasis due to obstruction
Prognostic factors
- Prognosis and survival excellent
Case reports
- 44 year old man with bronchial leiomyoma (Respir Med Case Rep 2014;12:59)
- 62 year old woman with vascular leiomyoma of lung (Int J Clin Exp Pathol 2013;6:97)
Treatment
- Resection is curative
Clinical images
Images hosted on other servers:
Bronchoscopy
White, smooth ovoid lesion
Gross description
- Endobronchial lesion may be attached by a broad stalk
- Firm, white, well circumscribed nodule
Gross images
Images hosted on other servers:
Bronchoscopic resection
Microscopic (histologic) description
- Bland proliferation of intersecting and whorled smooth muscle fascicles
- Fusiform spindle cells with no atypia, no hypercellularity, no necrosis, no mitoses
- May show fibrosis and hyalinization
Microscopic (histologic) images
Images hosted on other servers:
Bronchial leiomyoma:
Respiratory epithelium
Actin
Desmin+, myogenin-
Vascular leiomyoma
Tumor (center)
Mature smooth muscle
Small pulmonary arteries
SMA+
Van Gieson elastin
Differential diagnosis
- Benign metastasizing leiomyoma
- Low grade leiomyosarcoma
- Lymphangioleiomyomatosis
- Reactive smooth muscle proliferation/hyperplasia
- Spindle cell carcinoma
Additional references
