대한흉부영상의학회 Weekly Chest Cases

Case No : 1131 Date 2019-06-30

Courtesy of Ahn JH, Song JW / Inje University Haeundae Paik hospital
Age/Sex 38 / M
Chief ComplaintIncidental abnormality on routine examination

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Figure 4

Diagnosis With Brief Discussion

Diagnosis: Placental transmogrification
Radiologic Findings: Fig 1. Chest PA shows focal nodular opacity in right lower lung zone.
Fig 2-3. CT scans reveals about 1.9cm sized irregular subpleural solid nodule with cystic component at lateral basal segment of right lower lobe
Fig 4. Slightly increased size of the irregular solid nodule with cystic component on low dose chest CT taken on 2 months later
Brief Review: Placental transmogrification is a very rare lung disease, where the alveoli resemble the chorionic villi of placenta. It most commonly presents as a cystic lung lesion that is frequently accompanied with other pulmonary cystic lesions. However, the lesion can also occur in conjunction with non-cystic lung lesions such as fibrochondromatous hamartoma and pulmonary lipomatosis, and can present as a solitary pulmonary nodule. Clinically, the disease usually occurs in men between 20 and 50 years old. However, its exact etiology and pathogenesis still remains unclear.

There are three manifestations of placental transmogrification in radiologic findings, the most common of which is bullous emphysema. The disease can also be expressed on radiography with a mixed pattern of thin-walled cystic lesions and nodules. Radiologic images also rarely show a solitary nodule pattern. The image finding alone has limited value in differentiate a lesion from placental transmogrification. Therefore, making a diagnosis requires the confirmation of pathology.
Please refer to
References: 1. Kim JW, Park IH, Kwon W, Eom MS, Kim YJ, Oh JH. Placental transmogrification of the lung. Korean J Radiol. 2013;14:977-980.
2. G.R. Ferretti, M.Kocier, D.Moro-Sibilot, P.Y.Brichon, S.Lantuejoul. Placental transmogrification of the lung:CT-pathologic correlation of a rare pulmonary nodule.AJR 2004;183:99-101
3. Park ES, Han JH, Koh WJ, Lee KS, Kim JG, Seo JW, Kim JY. Placental transmogrification of the lung. Korean J Pathol.2008;42:308-310
Keywords: lung, Placental transmogrification,

No. of Applicants : 63

▶ Correct Answer : 21/63, 33.3%

- Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
- Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
- Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
- Mayo Clinic , United States AKITOSHI INOUE
- Chonbuk National University Hospital , Korea (South) MINGI SHIN
- Other , Korea (South) SEONGSU KANG
- Seoul National University Hospital , Korea (South) Ju Gang Nam
- , Korea (South) JAE KWANG LIM
- Chonbuk National University Hospital , Korea (South) YOUNGKWANG LEE
- Ajou University Hospital , Korea (South) DAYOUNG KIM
- Ajou University Hospital , Korea (South) HYERIN KIM
- Chonbuk National University Hospital , Korea (South) KUM JU CHAE
- Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
- Toranomon Hospital , Japan KAORU SUMIDA
- Ichinomiya Nishi Hospital , Japan Takao Kiguchi
- National Center for Global Health and Medicine , Japan HIROSHI TAKUMIDA
- Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
- Ajou University Hospital , Korea (South) YONG HO JANG
- Seoul Veterans Hospital , Korea (South) HYUN JUNG YOON
- Ajou University Hospital , Korea (South) YOO YOUNGJIN
- Jiangsu province hospital , China WANGJIAN ZHA

▶ Correct Answer as Differential Diagnosis : 6/63, 9.5%

- Vita Hospital , Brazil DIOGO LAGO PINHEIRO
- Fujieda Municipal General Hospital , Japan HAYATO NOZAWA
- TB centre kasaragod. , India rikhy krishnan
- , Japan YUMI MAEHARA
- Hamamatsu University Hospital , Japan YUKI HAYASHI
- the first affiliatited hospital of nanjing medical univercity , China HAI XU

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 1131 Date 2019-06-30

Discussion

No. of Applicants : 63