대한흉부영상의학회 Weekly Chest Cases

Case No : 168 Date 2001-01-13

Courtesy of Kyung Joo Park, MD / Ajou University Medical Center, Suwon, Korea
Age/Sex 74 / F
Chief ComplaintDyspnea and fever fro 3 weeks

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Diagnosis With Brief Discussion

Diagnosis: Sclerosing Hemangioma complicated by pneumonia
Radiologic Findings: Chest radiograph (Fig. 1) shows a large mass shadow with a lobulating contour in the right lower lung zone.
A cavity with an air-fluid level is visible within the mass shadow.
Contrast-enhanced CT scans through the lower thorax (Fig. 2-4) demonstrate a mass in the right middle lobe containing multiple air pockets and irregular dense calcifications.
The mass has a thin calcified rim and heterogeneous internal densities including necrotic and solid areas, and is surrounded by airspace consolidation in the periphery of right middle lobe.
There are multiple enlarged bronchopulmonary lymph nodes.
Brief Review: In pathologic examination, this mass was a well-encapsulated lesion with surrounding pneumonia.
This patient also had a history of empyema 4 months before the admission.

Im et al. reported that 3 of 8 patients with sclerosing hemangioma had calcification, and two had well-defined areas of low attenuation.
Cavitation is unusual finding in sclerosing hemangioma.
However, two cases have been reported in which an air-meniscus sign was identified, probably the result of disparate rates of contraction of the capsule and tumor.
The appearance of an air-fluid level in this case is more likely due to complicated infection.
References: 1. Im JG, Kim WH, Han MC et al. Sclerosing hemangioma of the lung and interlobular fissures: CT findings. J Comput Assist Tomogr 1994; 18:34-38
2. Bahk YW, Shinn KS, Choi BS. The air meniscus sign in sclerosing hemangioma of the lung. Radiology 1978; 128:27-29
Keywords: Lung, Benign tumor,

No. of Applicants : 26

▶ Semi-Correct Answer : 20/26, 76.9%

- 嫄닿뎅
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- 源
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- 11th AIR FORCE HOSPITAL Byung-June Jo
- CHU Nancy-Brabois France Denis Regent
- Dong-A university Hospital Ki-Nam Lee
- Gachon Medical School Gil Medical Center Seo Joon Beom
- Matsuyama Red Cross Hospital, Matsuyama, Japan Shunya Sunami
- Ospedale di Fabriano, Italy Giancarlo Passarini
- Santa Maria delle Grazie Hospital-Pozzuoli, Naples, Italy Bianca Cusati
- Seoul National University Hospital Tae Jung Kim
- Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 168 Date 2001-01-13

Discussion

No. of Applicants : 26