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Weekly Chest CasesArchive of Old Cases

Case No : 852 Date 2014-02-24

  • Courtesy of Kun Young Lim, Hyae Young Kim, Soo Hyun Lee / National Cancer Center
  • Age/Sex 67 / F
  • Chief ComplaintAbnormal chest radiography
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Pleural schwannoma
Radiologic Findings
Chest radiograph shows a huge mass in right lower lung zone.
Chest CT scans show well-defined pleural based mass with heterogenous enhancement pattern.PET-CT image demonstrates a mass with heterogenous FDG uptake in right lower hemithorax(SUV 6.9).
Mass resection was performed and pathology confirmed pleural schwannoma.

Brief Review
Schwannoma is a rare neoplasm in the pleura. A typical schwannoma is S-100 protein positive (neurogenic) and has cellular (Antoni type A) and myxoid ( Antoni type B) component. The heterogeneous characteristics are caused by confluent areas of hypocellularity adjacent to densely cellular or collagenous regions, xanthomatous changes, and/or regions of cystic degeneration.
The CT appearance features well-defined margins, ovoid or round shapes, with attenuations between water and soft tissue on unenhanced imaging and heterogeneous on contrast-enhanced imaging because of cellularity differences, collagenous regions, xanthomatous changes, and cystic degeneration.
Heterogeneous contrast enhancement is due to variations in the degree of cellularity and loose cellularity with prominent diffuse edematous change, which may result in minimal contrast enhancement.

References
1. Hu S, Chen Y, Wang Y, Chen KM, Song Q. Clinical and CT manifestation of pleural schwannoma. Acta Radiol 2012; 53:1137
Keywords
Pleura, Benign tumor,

No. of Applicants : 81

▶ Correct Answer : 7/81,  8.6%
  • - Chonnam National University Hospital , Korea (South) Sungmin Moon
  • - CHU POITIERS , France SZTARK Guillaume
  • - Jeju national university hospital , Korea (South) Jeong sub Lee
  • - Chonnam National Univ. Hospital , Korea (South) Jaemyeong Jo
  • - Chonnam National University Hospital, Radiology department , Korea (South) Park jin
  • - Fukuyama City Hospital , Japan Mayu Uka
  • - C.B.H. Dpt of Imaging-Clinica , Italy Carlo Florio
▶ Correct Answer as Differential Diagnosis : 29/81,  35.8%
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - Northern Yokohama Showa university , Japan Kota Watanabe
  • - Ansan Sarang Hosp. , Korea (South) Jaecheon Oh
  • - National Hospital Organization Okinawa Hospital , Japan Yasuji Oshiro
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Nagasaki University Hospital, Department of Pathology , Japan TOMONORI TANAKA
  • - , Korea (South) Chan Park
  • - Royal Perth Hospital , Australia Yuranga Weerakkody
  • - Research Hospital, The Institute of Medical Science, The University of Tokyo , Japan Toshihiro Furuta
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - IRSA La Rochelle , France Denis Chabassiere
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Teikyo University Mizonokuchi Hospital , Japan Kaoru Sumida
  • - CLCC Rennes , France nicolas gautier
  • - Teikyo University Mizonokuchi Hospital , Japan Noriko Kobayashi
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - Niigata University , Japan Atsushi Uehara
  • - Chonnam Nationl University Hospital Radiology , Korea (South) juwon kim
  • - CLINIQUE STE CLOTILDE , Reunion patrick MASCAREL
  • - Chonnam national university hospital , Korea (South) INSOO JANG
  • - , Korea (South) Kim sungmo
  • - , Korea (South) yun young lee
  • - NASA SCANS , India RAKESH BHATIA
  • - Private sector , Greece Vasilios Tzilas
  • - TCM HOSPITAL OF ZIGONG , China Cao Cunyou
▶ Semi-Correct Answer : 2/81,  2.5%
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - kem , nims , India ashish sarode
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