대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Diagnosis

Pulmonary Capillary Hemangioma

Radiologic Findings

She had undergone serial chest CT examinations three times during two years for the evaluation of the solitary nodule in the right lower lobe. Initial chest CT image with mediastinal window setting showed a small solitary nodule of low attenuation (mean Hounsfield unit of -9) (Fig. 1). For two years, the lung nodule showed a slight decrease in its size and development of central air-bronchogram. However, final follow-up chest CT image with the lung window setting showed that the solid nodule had apparently changed into subsolid nodule with ground-glass halo (Fig. 2). This seemed to be suspicious for lung cancer, so she underwent wedge-resection to remove the nodule.

Brief Review

Tumors of capillary vessels in the lung are extremely rare. Pulmonary capillary hemangioma (PCH) is characterized by a proliferation of pulmonary capillaries in the alveolar septa, perivascular connective tissue, bronchial wall, and pleura. Histologically, PCH consists of dilated capillaries, lined by single-layered flattened endothelial cells. The border of PCH can be either well-circumscribed or relatively ill-defined. Thus, PCH can manifest as a localized cystic lesion or focal ground-glass opacity nodule on CT image. Although PCH commonly occurs in neonates or children, awareness of this clinical entity is important, because PCH is difficult to differentiate radiologically from early lung cancer such as adenocarcinoma.

References

1 Fugo K, Matsuno Y, Okamoto K et al (2006) Solitary capillary hemangioma of the lung: report of 2 resected cases detected by high-resolution CT. Am J Surg Pathol 30:750-753
2 Abrahams NA, Colby TV, Pearl RH, Chipps BE, Juris AL, Leslie KO (2002) Pulmonary hemangiomas of infancy and childhood: report of two cases and review of the literature. Pediatr Dev Pathol 5:283-292

Keywords

Lung, Vascular, Vascular, Vascular malformation,