腹式子宮全摘除後11年目に両側多発肺結節として発見された肺良性転移性平滑筋腫の1例

Pulmonary Benign Metastasizing Leiomyoma Found as Multiple Bilateral Lung Nodules 11 Years after Hysterectomy；Report of a Case

はじめに　良性転移性平滑筋腫（BML）は，組織学的には良性の子宮平滑筋腫であるにもかかわらず遠隔転移をきたし，臨床的に悪性の性質を有するまれな疾患である．われわれは，腹式子宮全摘除後11年目に発見されたBMLの1例を経験したので，文献的考察を加え報告する．

Pulmonary benign metastasizing leiomyoma （PBML） is a rare entity. We herein report a case of PBML found as multiple bilateral lung nodules 11 years after total hysterectomy. The patient was a 53-year-old woman with past surgical history of abdominal total hysterectomy for a uterine leiomyoma at the age of 42. She was referred to our department for further evaluation of multiple pulmonary nodules detected by a chest radiography. A chest computed tomography revealed multiple bilateral small lung nodules less than 10 mm in diameter. 18-fluorodeoxyglucose （FDG） positron emission tomography showed no significant FDG accumulation to these nodules. The patient finally underwent video assisted thoracoscopic wedge resection of the lower lobe of the right lung for surgical biopsy. The final pathological diagnosis was PBML, based on the comparative evaluation of the surgical specimens from the lung and the uterus. No evidence of enlargement in the remaining pulmonary nodules was noted for 9 months after surgical lung biopsy.