대한흉부영상의학회 Weekly Chest Cases

Case No : 401 Date 2005-07-04

Courtesy of So Yeon Kim, M.D.,Kyung-Hyun Do, M.D. / Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Age/Sex 50 / F
Chief ComplaintIncidentally detected mass on routine chest radiograph

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Diagnosis With Brief Discussion

Diagnosis: Sclerosing hemangioma
Radiologic Findings: Chest radiograph shows a well-defined mass in left upper lung zone. Contrast enhanced chest CT reveals progressive and delayed enhancement of the mass with some persistent low attenuation portion.

Gross photography of the mass demonstrates various composition of the tumor. Whitish portion seems to be composed of a fibrous tissue and dark portion composed of hemorrhage.
Brief Review: Also known as sclerosing pneumocytoma, sclerosing haemangioma of the lung is a rare benign neoplasm that occurs predominantly in young or middle-aged women. The tumor has different histologic component including solid, papillary, sclerotic, and hemangiomatous components. The lesion is characterized by a well-defined outline that is suggestive of a benign nature. With conventional CT, sclerosing hemangioma has been described as being a well-defined juxtapleural mass with good enhancement. Furthermore, the lesion may harbour high-, iso- and lowattenuating areas that correspond, to the angiomatous, solid/sclerotic, and cystic components of the tumour, respectively. Although there is no report about contrast enhancement pattern on dynomic CT, a report demonstrates peak enhancement occurs at 2minutes after the administration of Gd-DTPA on MR.
References: 1. Cheung YC, Ng SH, Chang JW, et al. Histopathological and CT features of pulmonary sclerosing haemangiomas. Clin Radiol 2003;58:630-635.

2. Nakanishi K, Kohzaki S, Fujimoto S, Horita Y, Hayashi K. Pulmonary sclerosing hemangioma: report of a case with emphasis on dynamic MR imaging findings. Radiat Med 1997;15:117-119.

Please also refer to Case 142, Case 268.
Keywords: Lung, Benign tumor,

No. of Applicants : 27

▶ Correct Answer : 13/27, 48.1%

- Yonsei University Hospital, Korea Eun Hye Yoo
- Ewha Womans University Mokdong Hospital, Korea Yookyung Kim
- Hangang SacredHeart Hospital, Korea Eil Seong Lee
- Annemasse, Polyclinique de Savoie, France Gay-Depassier
- Hanyang University Hospital, Seoul, Korea Yo Won Choi
- Radiologie Guiton, La Rochelle, France Denis Chabassiere
- Shinmasan Hospital, Korea Kyung Hwa Jung
- Ewha Womans University Hospital, Korea Shim Sung Shine
- Homs National Hospital, Homs, Syria Rami Abou Zalaf
- Annecy Hospital, France Gilles Genin
- Social Security Hospital, Ankara, Turkey Meric Tuzun
- ASL Bologna, Maggiore Hospital, Bologna, Italy Marcellino Burzi
- Max Hospital, New Delhi, India Vickrant Malhotra

▶ Correct Answer as Differential Diagnosis : 2/27, 7.4%

- Incheon Sarang Hospital, Incheon, Korea Jung Hee Kim
- Ping Tung Christian Hospital,Taiwan Jun-Jun Yeh

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 401 Date 2005-07-04

Discussion

No. of Applicants : 27