PMC10316221_01
A 42-year-old asymptomatic female presenting for pre-operative clearance before a Roux-en-Y gastric bypass. The posteroanterior chest radiograph shows multiple bilateral pulmonary nodules.
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F1
Pre-operative chest radiographs revealed numerous small bilateral lung nodules [Figure 1].
A 42-year-old asymptomatic female with numerous pulmonary nodules. Reformatted coronal computed tomography maximum intensity projection image confirms numerous well-circumscribed solid nodules throughout bilateral lungs measuring up to 1.2 cm (arrow).
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F2
Subsequent chest computed tomography (CT) confirmed numerous, well-circumscribed solid nodules throughout bilateral lungs measuring up to 1.2 cm [Figure 2].
A 42-year-old asymptomatic female with numerous solid pulmonary nodules. (a) 18-fluorodeoxyglucose (FGD) Positron Emission Tomography (PET)/Computed Tomography (CT) maximum intensity projection does not reveal any abnormal hypermetabolic activity. Axial PET (b), CT (c), and fused PET/CT (d) images show the pulmonary nodules have minimal FDG uptake (less than mediastinal blood pool).
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F3
No abnormal hypermetabolic foci were present on the PET/CT [Figure 3].
A 42-year-old asymptomatic female with numerous solid pulmonary nodules. Cytology from lung nodule shows bland spindle cell proliferation with entrapped Type II pneumocytes. The bland spindle cells are positive estrogen receptor. Taken together, the findings are consistent with metastasizing leiomyoma.
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F4
Type II pneumocytes, consistent with BML [Figure 4]. The patient was referred to gynecologic oncology for further management.