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Weekly Chest CasesArchive of Old Cases

Case No : 1499 Date 2026-07-13

  • Courtesy of Juyeon Yi / Samsung Medical Center
  • Age/Sex 46 / F
  • Chief ComplaintPersistent abnormal CT findings
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Placental transmogrification
Radiologic Findings
Fig 1. Chest radiograph shows a large area of emphysematous change in left upper lung field with mediastinal shift. An irregular dense consolidation is noted in the left lower lung field.
Fig 2. Chest CT shows multiple large cystic lesions in the left lower lobe with hyperinflation of the left lung, resulting mediastinal shift.
Fig 3. Chest CT demonstrates bronchopneumonia-like consolidation along the bronchovascular bundles. Tiny nodules coalescing into consolidation, nodular interlobular septal thickening and clustered interstitial nodules are also observed.
Fig 4. Chest CT reveals dilation of the left lower lobar pulmonary vein.
Fig 5. Chest CT obtained 1 year earlier shows imaging findings similar to those of the current study.
Brief Review
Placental transmogrification of the lung (PTL) is a rare pathological condition affecting the lungs. It is characterized by the presence of papillary structures within the lung parenchyma that morphologically resemble the chorionic villi of the placenta. Despite this histopathologic resemblance, PTL does not contain any biological components of placental tissue.
The cores of these papillary structures consist of edematous or fibrotic interstitium composed of proliferating blood vessels, lymphoid cells, smooth muscle, adipose tissue, and interstitial cells with abundant clear cytoplasm. Although several hypotheses regarding the pathogenesis of PTL have been proposed, its exact etiology remains unclear.
It is known to usually occur in men between 20 to 50 years old. Patients may be asymptomatic or may present with pneumothorax, chronic obstructive pulmonary disease, bronchopneumonia, or respiratory distress.
To date, there have only been several case reports describing the CT findings of PTL. Radiologically, PTL typically appears as a bullous and cystic lesion involving unilateral lung, and rarely as a solitary pulmonary nodule with or without an associated cystic lesion.
Additional radiologic features that may aid in the diagnosis of PTL include nodular interlobular septal thickening, clustered interstitial nodules that may coalesce into areas of dense consolidation, and dilated pulmonary vasculature.
References
1. Kim JW, Park IH, Kwon W, Eom MS, Kim YJ, Oh JH. Placental transmogrification of the lung. Korean J Radiol. 2013;14(6):977-980.
2. Shin SH, Cha YK, Kim JH, et al. Placental transmogrification of the lung: CT findings with pathologic correlation in six patients. J Thorac Dis. 2023;15(9):4818-4825.
3. Ferretti GR, Kocier M, Moro-Sibilot D, Brichon PY, Lantuejoul S. Placental transmogrification of the lung: CT-pathologic correlation of a rare pulmonary nodule. AJR Am J Roentgenol. 2004;183(1):99-101.
Keywords

No. of Applicants : 77

▶ Correct Answer : 24/77,  31.2%
  • - , Japan HIROKI SAKURADA
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Inje University Ilsan Paik Hospital , Korea (South) MINSEOK CHOI
  • - Chonbuk National University Hospital , Korea (South) EUNCHONG LEE
  • - Chonbuk National University Hospital , Korea (South) YONG HWAN JO
  • - Secomedic Hospital , Japan FUMINORI MIYOSHI
  • - Inje University Pusan Paik Hospital , Korea (South) GANGWON JEONG
  • - The Catholic University of Korea Seoul St. Mary , Korea (South) JIHO PARK
  • - Chonbuk National University Hospital , Korea (South) JUNGHOON OH
  • - The Catholic University of Korea Yoeuido St. Mary , Korea (South) OHMIN KWON
  • - Chonbuk National University Hospital , Korea (South) YEEUN LEE
  • - Chonbuk National University Hospital , Korea (South) SEUNG HO LEE
  • - , Japan SHUNJIRO NOGUCHI
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Seoul Medical Center , Korea (South) HANSEUL CHO
  • - Chungbuk National University Hospital , Korea (South) HUISU LEE
  • - Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
  • - Fukuoka university , Japan KEISUKE SATO
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Matsunami General Hospital , Japan TARO TAKEDA
  • - Ehime University , Japan TOMOHISA OKADA
  • - Chonbuk National University Hospital , Korea (South) HYEONG RYUN CHO
  • - Other , Korea (South) CHAWOONG JEON
  • - , Korea (South) JIYUN KIM
▶ Correct Answer as Differential Diagnosis : 5/77,  6.5%
  • - Oita university , Japan AYUMI KAMEI
  • - Kyoto University Hospital , Japan YUSUKE UTSUNOMIYA
  • - Other , Korea (South) SEONGSU KANG
  • - Teikyo University Hospital, Mizonokuchi , Japan TOSHIHIRO FURUTA
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
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