Primary Endobronchial Leiomyoma Combined with Uterine Leiomyoma

자궁근종을 동반한 원발성 기관지 평활근종

  • Shim, Hyun Jeong (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Lim, Jung-Hwan (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Lee, Seok (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Kim, Dae Hyun (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Park, Kang Jin (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Lee, Se Ryeon (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Jeong, Jong-Pil (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Son, Jun-Gwang (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Kim, Soo-Ok (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Oh, In-Jae (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Kim, Kyu-Sik (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Kim, Yu-Il (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Lim, Sung-Chul (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Kim, Young-Chul (Department of Internal medicine, School of Medicine, Chonnam National University) ;
  • Kim, Seok-Mo (Department of Obstetrics and Gynecology, School of Medicine, Chonnam National University) ;
  • Na, Kook-Joo (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Chonnam National University)
  • 심현정 (전남대학교 의과대학 내과학교실) ;
  • 임정환 (전남대학교 의과대학 내과학교실) ;
  • 이석 (전남대학교 의과대학 내과학교실) ;
  • 김대현 (전남대학교 의과대학 내과학교실) ;
  • 박강진 (전남대학교 의과대학 내과학교실) ;
  • 이세련 (전남대학교 의과대학 내과학교실) ;
  • 정종필 (전남대학교 의과대학 내과학교실) ;
  • 손준광 (전남대학교 의과대학 내과학교실) ;
  • 김수옥 (전남대학교 의과대학 내과학교실) ;
  • 오인재 (전남대학교 의과대학 내과학교실) ;
  • 김규식 (전남대학교 의과대학 내과학교실) ;
  • 김유일 (전남대학교 의과대학 내과학교실) ;
  • 임성철 (전남대학교 의과대학 내과학교실) ;
  • 김영철 (전남대학교 의과대학 내과학교실) ;
  • 김석모 (전남대학교 의과대학 산부인과학교실) ;
  • 나국주 (전남대학교 의과대학 흉부외과학교실)
  • Received : 2006.08.23
  • Accepted : 2006.09.22
  • Published : 2006.11.30

Abstract

Leiomyoma of the bronchus is a very rare benign tumor of the lung. Most endobronchial leiomyomas occur as secondary foci of primary uterine leiomyoma. We herein report a case with endobronchial tumor that had a different pathology from a primary resected uterine leiomyoma and was therefor considered a primary endobronchial leiomyoma. A 51-year-old woman with a history of uterine myoma presented with productive cough and fever. Bronchoscopy revealed a lightly yellow colored mass lesion that totally obstructed the orifice of the left lower lobe of the lung. The diagnosis of leiomyoma was made by histological examination of the obtained specimen. We considered the possibility of a benign metastasizing pulmonary leiomyoma. For treatment and differential diagnosis, a left lower lobe lobectomy of the lung and total hysterectomy with bilateral salphingooopherectomy were performed. The differences between lung and uterine lesions were confirmed by morphologic finding and immunohistochemical staining. The pathological diagnosis was primary endobronchial leiomyoma combined with uterine myoma.

자궁근종의 병력을 가진 51세 여자가 기침, 가래, 발열을 주소로 내원하였다. 기관지내시경하 조직 생 검상 평활근종이 발견되었고 환자의 자궁근종의 병력을 고려했을 때 양성 전이성 폐평활근종과의 감별이 필요하였다. 좌하엽 절제술과 동시에 자궁 절제술을 시행하였고 두 병변의 조직학적 소견을 비교해 보았을 때 폐의 병변은 자궁근종과는 무관한 원발성 기관지 평활근종으로 확진되었으며 이후 증상의 호전을 보여 현재 경과관찰 중이다.

Keywords

References

  1. White SH, Ibrahim NB, Forrester-Wood CP, Jeyasingham K. Leiomyomas of the lower respiratory tract. Thorax 1985;40:306-11 https://doi.org/10.1136/thx.40.4.306
  2. Yellin A, Rosenman Y, Lieberman Y. Review of smooth muscle tumours of the lower respiratory tract. Br J Dis Chest 1984;78:337-51 https://doi.org/10.1016/0007-0971(84)90166-9
  3. Kayser K, Zink S, Schneider T, Dienemann H, Andre S, Kaltner H, et al. Benign metastasizing leiomyoma of the uterus: documentation of clinical, immunohistochemical and lectin-histochemical data of ten cases. Virchows Arch 2000;437:284-92 https://doi.org/10.1007/s004280000207
  4. Steiner PE. Metastasizing fibroleiomyoma of the uterus: report of a case and review of the literature. Am J Pathol 1939;15:89-109
  5. Arrigoni MG, Woolner LB, Bernatz PE, Miller WE, Fontana RS. Benign tumors of the lung: a ten-year surgical experience. J Thorac Cardiovasc Surg 1970; 60:589-99
  6. Ayabe H, Tsuji H, Tagawa Y, Tomita M, Tsuda N, Chen J. Endobronchial Leiomyoma: report of a case treated by bronchoplasty and a review of the literature. Surg Today 1995;25:1057-60 https://doi.org/10.1007/BF00311694
  7. Foroughi E. Leiomyoma of the trachea. Dis Chest 1962;42:230-2 https://doi.org/10.1378/chest.42.2.230
  8. Orlowski TM, Stasiak K, Kolodziej J. Leiomyoma of the lung. J Thorac Cardiovasc Surg 1978;76:257-61
  9. Lee SC, Park MS, Chung JH, Kim YS, Kim KD, Chang J, et al. Two cases of bronchial leiomyoma initially misdiagnosed as bronchial asthma. Tuberc Respir Dis 2003;55:616-22 https://doi.org/10.4046/trd.2003.55.6.616
  10. Yamada H, Katoh O, Yamaguchi T, Natsuaki M, Itoh T. Intrabronchial leiomyoma treated by localized resection via bronchotomy and bronchoplasty. Chest 1987;91:283-5 https://doi.org/10.1378/chest.91.2.283
  11. Choi JC, Yu CM, Ryu YJ, Jeon K, Choi KA, Kwon OJ, et al. The role of endoscopic surgery for completely obstructive endobronchial benign tumor. Korean J Intern Med 2006;21:15-9 https://doi.org/10.3904/kjim.2006.21.1.15
  12. Park SY, Lim EJ, Jang JS, Kim CH, Jee HK, Cho SJ, et al. Benign metastasizing pulmonary leiomyoma with hemoptysis. Tuberc Respir Dis 2006;60:92-6. https://doi.org/10.4046/trd.2006.60.1.92
  13. Esteban JM, Allen WM, Schaerf RH. Benign metastasizing leiomyoma of the uterus: histologic and immunohistochemical characterization of primary and metastatic lesions. Arch Pathol Lab Med 1999123:960-2
  14. Banner AS, Carrington CB, Emory WB, Kittle F, Leonard G, Ringus J, et al. Efficacy of oophorectomy in lymphangioleiomyomatosis and benign metastasizing leiomyoma. N Engl J Med 1981;305:204-9 https://doi.org/10.1056/NEJM198107233050406
  15. Hague WM, Abdulwahid NA, Jacobs HS, Craft I. Use of LHRH analogue to obtain reversible castration in a patient with benign metastasizing leiomyoma. Br J Obstet Gynaecol 1986;93:455-60 https://doi.org/10.1111/j.1471-0528.1986.tb08653.x