Miliary pattern as presentation of leiomyomatosis of the lung

A 30-year-old woman presented with progressive dyspnea on exertion and a rapidly-growing uterine mass. Chest x-ray examination revealed a miliary interstitial nodular pattern in both lung fields. Transbronchial biopsy yielded lung tissue containing multiple nodules of smooth muscle, consistent with benign metastasizing leiomyoma. Subsequent hysterectomy revealed an atypical cellular leiomyoma. We wish to emphasize the need for chest x-ray examination in the workup of uterine tumors in women of reproductive age.