We discontinued antituberculosis therapy two months later; after

both endobronchial biopsy and bronchoalveolar lavage cultures for mycobacteria returned negative. The treatment for endobronchial leiomyoma depends on its location in the airway as well as the size and width of the lesion. Most endobronchial leiomyomas reported in the literature have been resected either by lobectomy or pneumonectomy [9]; however less invasive procedures have been reported as safe alternatives including simple bronchoscopic removal with or without laser [6], bronchoplasty, or bronchotomy [10] utilizing sleeve resection of the involved bronchus while sparing the distal lung this website resection. Parenchymal resection is appropriate if there is a solitary parenchymal nodule or end-stage infection Buparlisib nmr distal to the obstruction [11]. Bronchoscopic intervention is the modality of choice nowadays if the lesion is not wide based [6]. The prognosis of leiomyoma is excellent after complete resection with rare recurrence with only two cases reported [6] and [12]. Our patient underwent flexible bronchoscopy, during which limited endobronchial biopsies were obtained due to bleeding. He was referred then to thoracic surgery team for resection. A right lung bilobectomy (middle and lower lobes) was carried out via video assisted thoracoscopic surgery (VATS) due to its large

size, wide base and suspected extraluminal extension, which would render it not amenable to bronchoscopic resection or bronchoplasty. The patient had an uneventful post-operative course and was followed up in our outpatient clinic. Post surgical pulmonary function tests were within normal limits. The diagnosis of leiomyoma can

not be made by imaging alone since there are no pathognomonic features. Atelectasis is the most frequent finding in chest radiographs for endobronchial leiomyomas [11], but other findings such as normal imaging, solitary round mass, pneumonic infiltration, unilateral emphysema or hyperlucency due to air trapping distal to the obstructed bronchus can be found [2]. Most benign endobronchial tumors produce Molecular motor non-specific masses in the wall of the airways, except for lipoma and cartilaginous tumors, which may show fat and calcium respectively. Hamartomas can also have both features [10]. Four cases of leiomyomas with calcification have been reported [5] and [10]; feature that was not present in this case. Computed tomography is an excellent tool of investigating bronchial lesions and for delineating leiomyomas in the bronchial tree. Its sensitivity to detect obstructive lesions in the respiratory tract varies from 60 to 100% [13]. Leiomyomas have an attenuation of 25–46 Hounsfield units on unenhanced CT and 46–85 Hounsfield units on contrast enhanced CT [3]. Tracheal leiomyomatosis (TL) appears similar to other benign tumors on CT; including lipomas and neurogenic tumors.