대한흉부영상의학회 Weekly Chest 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
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

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 540 Date 2008-03-03

Discussion

No. of Applicants : 74