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BACKGROUND@#Pulmonary sclerosing pneumocytoma (PSP) is rare benign lung tumor which usually develops in middle-aged women without typical clinical and imaging findings. PSP consists of two basic cell types (surface cubic epithelial cells and round mesenchymal cells) and four histological types (hemorrhagic, sclerotic, solid and papillary). It grows slowly, but it can metastasize to distant organs. The pathology before surgery is easily misdiagnosed. This study aims to improve clinicians' understanding of PSP by discussing the clinical characteristics of the disease.@*METHODS@#This represents a retrospective study of thirty-five patients diagnosed with pulmonary sclerosing pneumocytoma by pathological examination from January 2011 to December 2019.@*RESULTS@#A total of 35 patients in this study, 12 cases were male and 23 cases were female, the average age is 51 years old. 7 cases were discovered accidentally by physical examination or routine chest computed tomography (CT), and 28 cases were found due to symptoms such as cough, sputum, hemoptysis and chest pain. The imaging changes is mainly featured with isolated or clear circular or round-like single nodule and lump in the lungs. In this group, 12 cases underwent percutaneous lung biopsy, only 7 cases were diagnosed with PSP. A total of 28 patients underwent surgery, 24 cases underwent rapid frozen pathological biopsy, only 5 cases diagnosed with PSP. Postoperative pathological examination results shows that 1 case was diagnosed with keratotic squamous cell carcinoma with partial PSP, and the rest were diagnosed with PSP. The surgical and non-surgical patients were followed up for 1 to 8 years after discharge, and the overall recovery was good. The patients were no recurrence and metastasis on chest CT review.@*CONCLUSIONS@#PSP is a clinically rare benign lung tumor, which is more common in middle-aged women. The clinical manifestations and imaging features are lack of significance. Percutaneous lung puncture pathological examination and intraoperative rapid frozen pathological sections often leads to misdiagnosis. Final diagnosis relies on postoperative pathological work-up for most cases.
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Objective To evaluate characteristics of CT and 18F-FDG PET/CT in pulmonary sclerosing hemangioma (PSH).Methods A retrospective study involving 12 patients (2 males,10 females;24-80 years old) confirmed as PSH by pathology from May 2012 to July 2014 was investigated.All patients underwent chest CT scan,including enhanced CT;and 5 cases underwent whole-body 18F-FDG PET/CT.All imaging data were collected and analyzed to find out a more effective diagnostic method.Results In 12 PSH patients,9 had single lesion,of which 4 involved left lung and 5 right lung.The rest 3 patients including 1 with two nodules located in the right lower lobe,and 2 with multiple nodules scattered in several lobes.Plain CT showed all lesions had uniformly isodensity,4 with calcification,3 with air meniscus sign.Contrast-enhanced CT examinations showed that the majority lesions were prominent enhancement and few moderate enhancement,all lesions showed vessel marginating sign and 6 with cystic and necrosis area.18F-FDG PET/CT examinations showed that the lesions displayed patchy pattern of mild to moderate uptake with SUVmax 2.2--4.0.Conclusions The characteristic CT features of PSH,especially the contrast-enhanced CT imaging,are important for diagnosis.18F-FDG PET/CT findings are extremely helpful in differentiating PSH from malignant lesions.
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Purpose To analyze retrospectively the clinicopahological characteristics and immuophenotype in 120 cases of pulmonary selerosing hemangioma ( PSH) . Methods Data of 120 cases of PSH were collected and reviewed, including gross features and frozen diagnosis, histopathological features, morphology in HE and immunohistochemical characteristics of tumor cells. Results PSH pres-ents a well-circumscribed mass with a sense of expansion after cutting, which showed a solid, grey to tan-yellow surface with foci of haemorrhage. Two kinds of tumor cells and four typical patterns with mixed forms, are often shown under light microscope (92/120, 76. 67%). Focal accumulation of histocytes and scattered mast cells were noted in some cases (83/120, 69. 17%). Both surface cells and round cells were TTF-1 and EMA positive. Surface cells expressed SP-A, CK and NapsinA. Round cells expressed vimentin. Conclusion Gross features and typical“two cell types, four patterns” contribute to PSH diagnosis. Meanwhile, foal accumulation of foam histocytes and scattered mast cells show a clue to PSH diagnosis and differential diagnosis.
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Sclerosing pneumocytoma (SP) of the lung is a rare benign neoplasm. Here, we describe an unusual presentation of SP with a wax-and-wane pattern of growth in a 47-year-old woman. Tumor diameter decreased over a 3-year follow-up period and then increased on serial follow-up computed tomography scans. The mass showed high signal intensity on both T1- and T2-weighted chest magnetic resonance imaging (MRI) and early enhancement with a plateau on dynamic MRI. We speculate that intratumoral bleeding and resorption processes accounted for the changes in tumor size.
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Female , Humans , Middle Aged , Lung/pathology , Magnetic Resonance Imaging/methods , Pulmonary Sclerosing Hemangioma/diagnosis , Tomography, X-Ray Computed/methodsABSTRACT
Pulmonary sclerosing hemangioma is a relatively rare neoplasm of the lung with polymorphic histologic features of 2 unifying cellular components including surface cuboidal cells and interstitial round cells. Pulmonary sclerosing hemangioma typically occurs in middle aged women with asymptomatic, peripheral, solitary, well-circumscribed lesions. Although it is pathologically benign, it reveals size growing and chest symptom. We here report a case of pulmonary sclerosing hemangioma in a 72-year-old woman. She presented chest discomfort. A chest radiography and a chest computed tomography scan showed growing size from 3.2x3.1 cm to 6.0x5.3 cm in left upper lung during 10 years' follow-up period. Surgical resection of lung revealed a distinct constellation of findings including 2 epithelial cell types, surface cells, and round cells, which form 4 architectural patterns, papillary, sclerotic, solid, and hemorrhagic. She was diagnosed as pulmonary sclerosing hemangioma and chest discomfort disappeared.
Subject(s)
Aged , Female , Humans , Middle Aged , Epithelial Cells , Follow-Up Studies , Lung , Lung Diseases , Pulmonary Sclerosing Hemangioma , ThoraxABSTRACT
ObjectiveTo study the expressions of Ki-67 and p53 in the surface cells and polygonal cells in pulmonary sclerosing hemangioma(PSH)and investigate the relation of cell proliferation index and biological behaviour of the tumor.MethodsDouble-staining immunohistochemistry was used to detect the expressions of Ki-67 and CK8/18 protein. Double immunofluorescence staining was used to detect the expressions of p53 and AE1/AE3 protein. ResultsThe positive signal of AE1/AE3 and CK8/18 were localized in cytomembrane of surface cells. The positive signal of Ki-67 and p53 were localized in cell nucleus of the two kinds of cells.The positive rate of Ki-67 was under 1％ in surface cells and 1％-10 ％ in polygonal cells. p53 protein was mainly expressed in polygonal cells (6/9, 33.3 ％) and only exsited in seldom surface cells.ConclusionThere are differences on cellular morphous and immunophenotype between the surface cells and polygonal cells.The proliferation index and gene mutation are all predominant in polygonal cells than in surface cells. The biological behaviour of PSH maybe mainly be decided by the polygonal cells.
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Objective To investigate the unusual CT features of pulmonary sclerosing hemangioma (SH). Methods Clinical and CT features of 25 patients of pulmonary SH proved with pathology were reviewed, among which 15 patients underwent plain and enhanced CT scan, 10 underwent only plain CT scan. Results Solitary nodules (20/25, 80.00%) and solitary mass (5/25, 20.00%) were found with CT. CT features included slight lobulation (6/25, 24.00%), calcification (6/25, 24.00%), ground glass opacity (2/25, 8.00%), emphysema (1/25, 4.00%), endobrochial variant (1/25, 4.00%), short speculation (1/25, 4.00%) and vascular bundle (2/25, 8.00%). Slight or remarkable enhancement was noticed in all 15 patients underwent contrast enhanced CT. Conclusion CT can reveal features and unusual manifestations of pulmonary SH, and is helpful to the diagnosis of pulmonary SH.
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Objective To investigate the diagnosis and therapy of the sclerosing hemangioma of the lung.Mothods The case history of 15 patients were analyzed retrospectively and summarized the diagnosis and therapy of the Sclerosing hemangioma of the lung.Results There were 2 males and 13 females(1:6.5).No patients were diagnosed this disease before operation for there were no specific imageology features.The tumor cell indicated pantomorphia and there were 3 cases were misdiagnosed during the operation frozen section pathology.The optimization therapy methods was to resect the tumor with the VATS.The prognosis of this disease was well and there were no cases recurrence in these 15 patients.Conclusion The sclerosing hemangioma of the lung was the benign tumor and there were no specific imageology features.The misdiagnosis was frequently before operation.To resect the tumor with the VATS was the optimal therapy method.
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Objective To analyze the imaging characteristics of pulmonary sclerosing hemangioma(PSH) and to improve the accurate rate of its diagnosis before surgery.Methods Imaging findings in 11 cases pathologically proved sclerosing hemangiomas were retrospectively analyzed in comparison with pathology.Results The imaging findings of PSH mostly were solitary masses with homogeneous density,and with smooth margin in 10 cases and irregular margin in 1 case;1 case with slight calcification and 1 case with air-meniscus sign were found.7 cases were homogeneous enhancement and 4 were heterogeneous enhancement on contrast-enhanced scan.The high and low attenuation areas on CT corresponded with angiomatous and cystic areas respecitvely on pathology.Conclusion Chest roentgenogram and unenhanced CT scan of PSH are not of remarkable characteristics,contrast-enhanced CT scan plays an important role in diagnosis and differential diagnosis of PSH.
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Forty patients with pulmonary sclerosing hemangioma treated from 1971 to 1999 in General itospital of PLA were analyzed retrospectively for clinical and pathological features,and image characteristics. The results showed that 60%(24 of 40) of patients were middle aged or elderly women,and 40% (16 of 40) of patients had symptoms.On chest radiography,the tumor presented as a round or nearly round nodule or mass with sharp and smooth margin in 37 cases(92 5%).All patients received operation without complication or mortality.Immunohistochemical findings indicated that the tumor cells were positive for neuroendocrine markers,and neurosecretory granules were found in tumor cells by electron microscopy.There was no recurrence or metastasis at the follow up. It suggested that pulmonary sclerosing hemangioma is a benign neuroendocrine tumor that has a good prognosis if it is treated by operation.