J Korean Soc Radiol.  2020 Jan;81(1):225-230. 10.3348/jksr.2020.81.1.225.

A Rare Case of Tracheal Leiomyoma: Role of Digital Tomosynthesis in Diagnosis and Treatment

• Nam SW
• Jeong YJ
• Lee G
• Lee JW
• Eom JS
• Lee CH
• Park SM

• KMID: 2469198
• DOI: http://doi.org/10.3348/jksr.2020.81.1.225

Abstract

Tracheal leiomyoma is a rare benign tumor, which is composed of transformed cells of mesenchymal origin. We describe a case in which digital tomosynthesis was useful to evaluate a tracheal tumor that was overlooked on initial chest radiographs.

MeSH Terms

Diagnosis*
Leiomyoma*
Radiography, Thoracic
Tomography, X-Ray Computed
Tracheal Neoplasms

Figure

• 

  Fig. 1 A 58-year-old-woman with tracheal leiomyoma. A. Chest radiograph (left) shows no airway abnormalities. Digital tomosynthesis (right) shows a well-defined endotracheal nodule of 0.6 cm (arrowhead), 2.3 cm proximal to the carina. B. Axial and coronal computed tomography images show a well-defined homogeneous oval nodule of 0.6 cm (arrowheads) in the trachea with borderline-sized right upper paratracheal lymph nodes (arrow) of the trachea. C. Bronchoscopy shows a whitish polypoid nodule arising from the mid-trachea. D. Low-magnification photomicrograph (left) of a pathologic specimen obtained using bronchoscopic biopsy shows a nodule composed of subepithelial spindle cells. High-magnification photomicrograph (right) shows proliferation of spindle smooth-muscle cells with elongated eosinophilic cytoplasm and distinct cell membranes. E. Follow-up digital tomosynthesis conducted 2 days after the procedure shows no evidence of post-procedural complications. H&E = hematoxyin & eosin

Reference

1. White SH, Ibrahim NB, Forrester-Wood CP, Jeyasingham K. Leiomyomas of the lower respiratory tract. Thorax. 1985; 40:306–311.

2. Grillo HC, Mathisen DJ. Primary tracheal tumors: treatment and results. Ann Thorac Surg. 1990; 49:69–77.

3. Bharadwaj SC, Unruh HW. Leiomyoma of the trachea. Ann Thorac Surg. 2012; 93:669–670.

4. Kim YK, Kim H, Lee KS, Han J, Yi CA, Kim J, et al. Airway leiomyoma: imaging findings and histopathologic comparisons in 13 patients. AJR Am J Roentgenol. 2007; 189:393–399.

5. Manninen MP, Paakkala TA, Pukander JS, Karma PH. Diagnosis of tracheal carcinoma at chest radiography. Acta Radiol. 1992; 33:546–547.

6. Park SJ, Choo JY, Lee KY, Kim JH, Choi JW, Yeom SK, et al. Usefulness of digital tomosynthesis for the detection of airway obstruction: a case report of bronchial carcinosarcoma. Cancer Res Treat. 2015; 47:544–548.

7. Choo JY, Lee KY, Yu A, Kim JH, Lee SH, Choi JW, et al. A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference. Eur Radiol. 2016; 26:3147–3154.

8. Lee JH, Yang HJ, Kim MS, Lee JG, Kim DS, Kang KW. A case of tracheal leiomyoma treated by electrosurgical resection under rigid bronchoscopy. Korean J Med. 2012; 82:227–231.

9. Kwon YS, Kim H, Koh WJ, Suh GY, Chung MP, Kwon OJ, et al. Clinical characteristics and efficacy of bronchoscopic intervention for tracheobronchial leiomyoma. Respirology. 2008; 13:908–912.