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Weekly Chest CasesCases by Disease Category

Case No : 1254 Date 2021-11-02

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  • Courtesy of Youkyung Lee / Hanyang University Guri Hospital
  • Age/Sex 24 / F
  • Chief Complaintcough, X-ray abnormality was also noted 8 years ago
  • Figure 1
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  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6
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  • Figure 8

Diagnosis With Brief Discussion

Diagnosis
Sclerosing pneumocytoma
Radiologic Findings
Chest PA taken in 2020 showed a lobulated contour mass in the left mid lung zone. The mass was noted in Chest PA and smaller in 2012. On CT, the mass increased from 2.2cm to 3.8cm. The mass showed a dumbbell shape and with GGO halo in the lateral portion. There were satellite nodules in LUL. Satellite nodules in LUL increased in size and number.
Brief Review
Left upper lobectomy was done. There were multiple sclerosing pneumocytoma (40) without involvement of bronchial resection margin. There was no regional lymph node metastasis.

Sclerosing pneumocytoma (previously sclerosing hemangioma) is a lung tumor, arising from type II pneumocytes. This tumor usually occurs in middle-aged adults, with a male-to-female ratio of 1:5. The morphologic characteristics of sclerosing pneumocytoma include a solitary juxtapleural mass, circular or ovoid in shape, with smooth margins. The occurrence of multiple tumors is rare.
A case of multiple sclerosing hemangiomas in the right lung was reported (2005). A case of sclerosing pneumocytoma as clustered lung nodules with foci of ground-glass opacity localized in the right upper lobe was reported (2014). In a study of 76 patients with sclerosing pneumocytoma, 4 patients (5.3%) had two lesions, and two patients (2.6%) had >3 lesions (2015). A case of the main nodule with surrounding clustered satellite nodules mimicking active pulmonary tuberculosis in the right upper lobe was reported (2018).
References
Shin SY, Kim MY, Lee HJ, Oh SY, Jang SJ. Clustered pulmonary sclerosing pneumocytoma in a young man: a case report. Clin Imaging. 2014 Jul-Aug;38(4):532-535. doi: 10.1016/j.clinimag.2014.01.016. Epub 2014 Feb 7. PMID: 24667045.
Min A Lee, Tae Jung Kim, Joungho Han, Kyung Soo Lee. Pulmonary sclerosing pneumocytoma with multiple satellite nodules mimicking tuberculosis. Precision and Future Medicine 2018;2(2):76-78 https://doi.org/10.23838/pfm.2018.00051
Hishida T, Yoshida J, Nishimura M, Ishii G, Nishiwaki Y, Nagai K. Multiple sclerosing hemangiomas with a 10-year history. Jpn J Clin Oncol. 2005 Jan;35(1):37-9. doi: 10.1093/jjco/hyi002. PMID: 15681603.
Devouassoux-Shisheboran M, Hayashi T, Linnoila RI, KossMN, Travis WD. A clinicopathologic study of 100 cases ofpulmonary sclerosing hemangioma with immunohistochemical studies: TTF-1 is expressed in both round andsurface cells, suggesting an origin from primitive respiratory epithelium. Am J Surg Pathol 2000;24:906-16.

Shin SY, Kim MY, Oh SY, Lee HJ, Hong SA, Jang SJ, Kim SS. Pulmonary sclerosing pneumocytoma of the lung: CT characteristics in a large series of a tertiary referral center. Medicine (Baltimore). 2015 Jan;94(4):e498. doi: 10.1097/MD.0000000000000498. PMID: 25634202; PMCID: PMC4602969.
Please refer to
Case 1245 Case 1118 Case 1035 Case 1023
Keywords

No. of Applicants : 85

▶ Correct Answer : 29/85,  34.1%
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - , Japan HIROAKI ARAKAWA
  • - , Japan JUN KANZAWA
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - Niigata University , Japan ATSUSHI UEHARA
  • - Other , Korea (South) HYEJIN YANG
  • - Chonnam National University Hwasun Hospital , Korea (South) SEONGWOO CHO
  • - Osaka Red Cross Hospital , Japan YUSUKE UTSUNOMIYA
  • - NIMS, HYDERABAD , India BHASKAR K
  • - Inje University Haeundae Paik Hospital , Korea (South) HYUNGIN PARK
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - Asan Medical Center , Korea (South) EUNJI CHOI
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Ajou University Hospital , Korea (South) KYUNGMIN LEE
  • - , China FANG YING GEN
  • - Ajou University Hospital , Korea (South) HAEIN LEE
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
  • - Kyoto University Hospital , Japan YASUHISA KURATA
  • - Osaka City General Hospital , Japan SHU MATSUSHITA
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Other , Korea (South) MINSU KIM
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Scansworld , India PHILSON JOSEPH MUKKADA
  • - Kyoto University Hospital , Japan SATOSHI IKEDA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Chonnam National University Hospital , Korea (South) SEUNG WAN KANG
  • - , Korea (South) WONJU HONG
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
▶ Correct Answer as Differential Diagnosis : 16/85,  18.8%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Korea University Guro Hospital , Korea (South) SEOKYOUNG LEE
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - Other , Korea (South) MINGI SHIN
  • - Chungbuk National University Hospital , Korea (South) JIYUN KANG
  • - Other , Korea (South) SEONGSU KANG
  • - Chonbuk National University Hospital , Korea (South) JUNGHWAN KIM
  • - Osaka University , Japan AKINORI HATA
  • - Shimada General Medical Center , Japan HAYATO NOZAWA
  • - National Center for Global Health and Medicine , Japan MASATOSHI HOTTA
  • - Seoul National University Bundang Hospital , Korea (South) SUNG HYUN YOON
  • - Inje University Pusan Paik Hospital , Korea (South) JIYEON HAN
  • - Seoul Veterans Hospital , Korea (South) SEONG WON JANG
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
  • - , Japan YUKI HAYASHI
▶ Semi-Correct Answer : 2/85,  2.4%
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - The University of Tokyo Hospital , Japan HIROSHI TAKUMIDA
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