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Weekly Chest CasesArchive of Old Cases

Case No : 540 Date 2008-03-03

  • Courtesy of Sang Hyun Paik, MD, Choong Hee Shin, MD, Jai Soung Park, MD. / Department of Radiology, Soonchunhyang University Bucheon Hospital, Korea.
  • Age/Sex 65 / F
  • Chief ComplaintChest PA abnormality on a routine check-up, PHx: Total hysterectomy d/t cervical cancer (19 years ago)
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Sclerosing hemangioma
Radiologic Findings
Chest radiograph shows a well-defined, ovoid nodule in the left parahilar area.

There is about 20mm sized well-defined round nodule in left upper lobe. Pre-contrast CT scan (Fig.1-a) shows non-calcified, homogeneous soft tissue density nodule. After the contrast enhancement (Fig.1-b), the nodule is slightly enhanced on early contrast scan, and progressively enhanced (Fig.1-c) on delayed contrast CT scan.

After 4 years, follow up contrast enhanced CT scan(Fig.2) shows slightly increased size of nodule (25mm) with same nature in LUL.
Brief Review
Relatively rare, benign neoplasm of the lung
Predominantly affects females over 50 years of age
Composed of two types of cells: cuboidal cells that line papillary structures and round to polygonal cells that form solid sheets

CT findings
- Solitary, well defined lesion
- Located in periphery of lung
- Marked contrast enhancement caused by its hemangiomatous component

Histoligical patterns: epitheloid(solid), papillary, sclerotic and hemorrhagic
Biopsy: definitive diagnostic test
Please refer to
Case 142, Case 268, Case 401,
References
1. Im JG, Kim WH, Han MC, Han YM, Chung JW, Ahn JM, Do YS. Sclerosing hemangiomas of the lung and interlobar fissures: CT findings. J Comput Assist Tomogr 1994; 18 : 34-38
2. Nam JE, Ryu YH, Cho SH, Lee Y, Kim HJ, Lee DY, Choe KO, Kim SJ. Air-trapping zone surrounding sclerosing hemangioma of the lung. J Comput Assist Tomogr 2002; 26: 358-361
3. Sugio K, Yokoyama H, Kaneko S, Ishida T, Sugimachi K. Sclerosing hemangioma of the lung: radiographic and pathological study. Ann Thorac Surg 1992; 53: 295-300
Keywords
Lung, Benign tumor,

No. of Applicants : 74

▶ Correct Answer : 21/74,  28.4%
  • - China Medical University , Taiwan Jun jun Yeh
  • - National Taiwan University Hospital , Taiwan Chin-Chung Shu
  • - CHR ANNECY , France Olivier SEGALL
  • - Trakya Univercity School of Medicine armagan sarac
  • - GMCH chandigarh , India sonali jain
  • - Department of Radiology , Korea (South) Pyeong Guk Kang
  • - Yonsei university Shinchon Severance hospital , Korea (South) Na-young Shin
  • - Soonchunghyang university Bucheon hospital , Korea (South) Minhee Lee
  • - Daegu Fatima Hospital , Korea (South) Tae-Hun Kim
  • - National Taiwan University Hospital , Taiwan Chi Chen
  • - radiology department , France gilles GENIN
  • - Polyclinique de SAVOIE , France, Metropolitan GAY-DEPASSIER Philippe
  • - EKH-Berlin , Germany Michael Weber
  • - Homs National Hospital , Syria Rami Abou zalaf
  • - Regional Imaging Ltd. - Riverina , Australia Rashid Hashmi
  • - IRSA , France Jean-Luc BIGOT
  • - Depatment of Radiology, Yongsan Hospital, College of Medicine, Chgung-Ang University , Korea (South) Jae Seung Seo
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - Armed Forces Chun-Cheon Hospital , Korea (South) Chae Lim
  • - E-DA Hospital / I-Shou University , Taiwan Yu-Feng Wei
  • - Soonchunhyang University Cheonan Hospital , Korea (South) Sang Hyun Park
▶ Correct Answer as Differential Diagnosis : 7/74,  9.5%
  • - Seoul National University Hospital , Korea (South) Hyun Ju Lee
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - Toronto General Hospital, University of Toronto , Canada Yon Mi Sung
  • - CHU de Poitiers , France Paul ARDILOUZE
  • - PITTWATER RADIOLOGY , Australia Julie Arora
  • - PITTWATER RADIOLOGY , Australia Saurabh Khandelwal
  • - Gimpo Woori Hospital , Korea (South) Son Youl Lee
▶ Semi-Correct Answer : 33/74,  44.6%
  • - Az Osp Santa Maria , Italy angelo carloni
  • - hospital Sao Paulo , Brazil israel missrie
  • - Shiga University of Medical Science , Japan Norihisa Nitta
  • - MD PG Resident, PIMS,LONI, MAHARASHTRA, INDIA , India Sushant Bhadane
  • - Shinsegye Rad Clinic, Daegu, Korea , Korea (South) Gi Beom Kim
  • - seoul national university hospital , Korea (South) Ijin Joo
  • - All India Institute of medical sciences , India Justin Moses
  • - MEDINOVA DIAGNOSTICS , India Harsha NS
  • - Lilavati Hospital & Research Centre , India Mahavir Swami
  • - Vitalife Clinics , Pune , India. , India rahul deshmukh
  • - CHRU lille , France manuel toledano
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Hospital Universitario La Candelaria , Spain Ad Bz
  • - Osaka University , Japan Osamu Honda
  • - Kashan University of Medical Sciences, kashan, Iran , Iran Ebrahim Razi
  • - Saga University, Japan , Japan Ryoko Egashira
  • - Clinic 1 , Russian Federation Lepikhina Darya
  • - Almana.G.Hospital , Saudi Arabia Jamal Abazid
  • - JungAng Radiology Clinic , Korea (South) CHANGHO LEE
  • - liberal , France jerome hannequin
  • - Ruby Hall Clinic , India Aniruddha Joshi
  • - Hospital universitario Nuestra Sera De La Candelaria , Spain Luisa Elena Delgado
  • - vital imaging centre , India ganesh agrawal
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
  • - Mokpo HanKook Hospital , Korea (South) Sang Uk Park
  • - christie hospital , United Kingdom rohit kochhar
  • - Dongguk University International Hospital , Korea (South) Hee Seok Choi
  • - Pe d , France Fabrice Bing
  • - National Taiwan University Hospital , Taiwan Nin Chieh Hsu
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - oswal cancer hospital , India lovkesh mittal
  • - MAX HEALTH CARE , India vickrant malhotra
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