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Airway Leiomyoma: Imaging Findings and Histopathologic Comparisons in 13 Patients

¹ Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
² Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul Korea.
³ Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
⁴ Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

View larger version (127K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —63-year-old man (patient 4) with tracheal leiomyoma. Posteroanterior chest radiograph shows endotracheal nodule (arrow).

View larger version (128K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —63-year-old man (patient 4) with tracheal leiomyoma. Enhanced transverse (B) and coronal reformatted (C) CT scans show endotracheal nodule (arrow) with lobulated contour in intrathoracic trachea.

View larger version (107K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —63-year-old man (patient 4) with tracheal leiomyoma. Enhanced transverse (B) and coronal reformatted (C) CT scans show endotracheal nodule (arrow) with lobulated contour in intrathoracic trachea.

View larger version (129K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —63-year-old man (patient 4) with tracheal leiomyoma. Low-magnification photomicrograph of pathologic specimen obtained at segmental resection of trachea shows endotracheal tumor arising from membranous tracheal wall (arrow). (H and E, x10)

View larger version (130K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1E —63-year-old man (patient 4) with tracheal leiomyoma. High-magnification photomicrograph shows proliferation of spindle smooth-muscle cells. (H and E, x200)

View larger version (134K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1F —63-year-old man (patient 4) with tracheal leiomyoma. Photomicrograph of transverse section of resected trachea lesion shows strongly positive results. Both intratracheal and transmural (arrow) tumor growth are evident. (Immunostain for smooth-muscle actin, x10)

View larger version (110K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —55-year-old woman (patient 2) with tracheal leiomyoma of iceberg type. Posteroanterior chest radiograph shows intratracheal (arrowhead) and extratracheal (arrows) components of mass.

View larger version (70K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —55-year-old woman (patient 2) with tracheal leiomyoma of iceberg type. Enhanced transverse (B) and coronal-reformatted (C) CT scans show tracheal tumor of irregular contour with both intraluminal (arrowhead) and extraluminal (white arrows) components. Stippled calcifications (black arrow) are present within mass. Calcification was confirmed at microscopic examination.

View larger version (94K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —55-year-old woman (patient 2) with tracheal leiomyoma of iceberg type. Enhanced transverse (B) and coronal-reformatted (C) CT scans show tracheal tumor of irregular contour with both intraluminal (arrowhead) and extraluminal (white arrows) components. Stippled calcifications (black arrow) are present within mass. Calcification was confirmed at microscopic examination.

View larger version (128K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —55-year-old woman (patient 2) with tracheal leiomyoma of iceberg type. Photograph of gross pathologic specimen obtained at segmental resection of trachea shows well-encapsulated mass with lobulated contour.

View larger version (92K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —21-year-old man (patient 7) with recurrent bronchial leiomyoma and history of bronchial stenting for bronchial wall defect during bronchoscopic removal of leiomyoma in left main bronchus. Posteroanterior chest radiograph shows intrabronchial (arrowhead) and extrabronchial (arrows) components of mass in left main bronchus. Lateral displacement of azygoesophageal recess interface is evident in subcarinal area.

View larger version (111K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —21-year-old man (patient 7) with recurrent bronchial leiomyoma and history of bronchial stenting for bronchial wall defect during bronchoscopic removal of leiomyoma in left main bronchus. Lung (B) and mediastinal (C) window transverse CT scans show lobulated mass in left main bronchus. Intraluminal (arrowhead, B) and extraluminal (arrow) components of tumor are evident.

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —21-year-old man (patient 7) with recurrent bronchial leiomyoma and history of bronchial stenting for bronchial wall defect during bronchoscopic removal of leiomyoma in left main bronchus. Lung (B) and mediastinal (C) window transverse CT scans show lobulated mass in left main bronchus. Intraluminal (arrowhead, B) and extraluminal (arrow) components of tumor are evident.

View larger version (114K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —21-year-old man (patient 7) with recurrent bronchial leiomyoma and history of bronchial stenting for bronchial wall defect during bronchoscopic removal of leiomyoma in left main bronchus. Photograph of gross specimen of segmentally resected distal trachea and main bronchus (sleeve resection) shows well-circumscribed grayish-white solid mass measuring 2.5 x 2 x 1.5 cm. Intraluminal (arrowhead) and extraluminal (arrows) tumor components are evident.

View larger version (135K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —17-year-old boy (patient 6) with bronchial leiomyoma. Posteroanterior chest radiograph shows endobronchial nodule (arrow) in right main bronchus leading to atelectasis of right middle and lower lobes.

View larger version (160K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —17-year-old boy (patient 6) with bronchial leiomyoma. Enhanced transverse (B) and coronal reformatted (C) CT scans show oval tumor nodule (arrow) occupying right main bronchus and attendant atelectasis (arrowhead, C) of right middle and lower lobes.

View larger version (137K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —17-year-old boy (patient 6) with bronchial leiomyoma. Enhanced transverse (B) and coronal reformatted (C) CT scans show oval tumor nodule (arrow) occupying right main bronchus and attendant atelectasis (arrowhead, C) of right middle and lower lobes.

View larger version (96K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4D —17-year-old boy (patient 6) with bronchial leiomyoma. Low-magnification photomicrograph of pathologic specimen obtained with bronchoscopic snaring shows nodule composed of subepithelial spindle cells. (H and E, x12)

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