CXR Case 077
A 48 year old lady is sent in from respiratory clinic with worsening breathlessness and hypoxaemia.
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There are multiple small nodular lesions bilaterally, with a predominately basal distribution.
No pleural involvement.
This is leiomyomatosis.
The basal distribution and multiple different sizes of lesions suggests haematogenous spread of tumour, in this case uterine myomas.
Leiomyomatosis is results from haematogenous spread of ‘benign’ uterine fibroid.
There is commonly a venous tumour burden, masquerading as DVT / PE.
Treatment is with hysterectomy and anti oestrogen / gonadotrophin analogues as the cells are very hormone responsive.
There is a rare hereditary form of leiomyomatosis that also includes renal cell cancer and cutaneous lesions
Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar | ICIS Course ANZ