Analysis of Primary Tracheal Leiomyoma (One Case Analysis)

WANG Yan-mina; HAN Feng-fenga; PENG Juana; GUAN Wen-binb; YANG Tian-yuna; SUN Jin-yuana; GUO Xue-juna

doi:10.3969/j.issn.1002-3429.2016.09.005

Abstract：Objective To investigate the pathological and clinical features of primary tracheal leiomyoma in order to reduce the misdiagnosis and missed diagnosis rates. Methods Clinical data of 1 patient with primary tracheal leiomyoma ad-mitted to our hospital was retrospectively analyzed. Results A 58-year-old female was admitted for a cough accompanied by a fever, chest distress and a chest pain. Chest CT showed a nodule on the posterior wall of upper trachea. The pathological re-port of transbronchial biopsy was chronic inflammation of mucous membranes. PET-CT showed the right posterior wall of the thoracic inlet level tracheal for a lesion with increased fluorodeoxyglucose ( FDG) metabolism, indicating that it might be ma-lignant. A space occupying lesion was found on the posterior wall of the uterine body. The FDG metabolism of the lesion was increased. It was not certain whether it was infection of uterine fibroids or malignancy. The wall of the gastric antrum was thickened, with increased FDG metabolism ( which was confirmed by gastroscope biopsy to be astral gastritis) . High frequency electric snare via bronchoscope was used to inspect the lesion which was later confirmed as primary tracheal smooth muscle tumor by pathological examination ( excluding uterine origin) . The patient received symptomatic supportive treatment and was discharged after relief ( uterine fibroids specialist treatment) . One month later, the examination showed that the bronchial wall was healed, and slight extension could be seen. There was no obvious sign of recurrence, and a follow-up was recommended. Conclusion Primary tracheal leiomyoma is rare and not specific. It tends to be easily misdiagnosed as chronic bronchitis and asthma. Early 3-D spiral CT and bronchoscope are helpful in the diagnosis.