Diffuse cavitary benign metastasising leiomyoma of the lung

A 49-year-old woman presented to the pulmonary outpatient clinic with a 4-year history of cough and dyspnoea. Physical examination showed bilateral coarse breath sounds. Pulmonary function tests showed mixed ventilatory defects and small airway obstruction. Chest CT (figure 1) revealed diffuse pulmonary nodules smaller than 1 cm with cavitation. Pelvic ultrasonography revealed a uterine leiomyoma measuring 4×3 cm. A video-assisted thoracoscopic surgery wedge biopsy of the left lingular segment was performed. Microscopic examination revealed the nodules were composed of cytologically benign spindle cells without atypia (figure 2A,B). These spindle cells were positive for alpha-smooth muscle actin (figure 2C), oestrogen (figure 2D) and progesterone (figure 2E) receptor, and negative for D2-40, …