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Weekly Chest CasesCases by Disease Category

Case No : 1373 Date 2024-02-14

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  • Courtesy of Ji Young Lee, Hye Soo Cho, Woo Hyeon Lim / Seoul National University Hospital
  • Age/Sex 39 / F
  • Chief ComplaintIncidental abnormality
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Pulmonary placental transmogrification
Radiologic Findings
Fig 1. Chest PA shows irregular mass like consolidation in right lower lung zone.
Fig 2-5. CT scans reveals about 2.8 cm sized irregular subpleural nodule with cystic component at right lower lobe.
Brief Review
Pulmonary placental transmogrification is known to be a very rare disease. Histologically, pulmonary placental transmogrification resembles the chorionic villi of placenta, but the tissues do not bear any biologic properties of the placenta. The origin and pathogenesis remain unknown. It is thought to be a reactive lesion secondary to emphysema. A villous transformation is thought to arise from edema and fibrosis of pulmonary strands of severe emphysema or giant bullous emphysema. However, a congenital origin has not been excluded. Pulmonary placental transmogrification is distinguished from typical emphysema by the tendency to occur in the younger age group along with the local progression of the disease. The prognosis after surgical resection is excellent.
There are three manifestations of placental transmogrification in radiologic findings. The most common manifestation is bullous emphysema pattern. Next, the disease is expressed on radiography with a mixed pattern of thin-walled cystic lesion and nodule. Rarely, the radiologic finding shows a solitary nodule pattern. Radiologically, differential diagnosis of the lesion includes cystic or bullous lung disease, such as bullous emphysema, particularly giant bullous emphysema and solitary pulmonary lung nodules, such as hamartoma. However, the image finding alone has limited value to differentiate the lesion from placental transmogrification. Therefore, making the diagnosis requires the confirmation of pathology.
References
1. Kim JW, Park IH, Kwon W, Eom MS, Kim YJ, Oh JH. Placental transmogrification of the lung. Korean J Radiol. 2013;14:977-980.
2. G.R. Ferretti, M.Kocier, D.Moro-Sibilot, P.Y.Brichon, S.Lantuejoul. Placental transmogrification of the lung:CT-pathologic correlation of a rare pulmonary nodule.AJR 2004;183:99-101
Keywords

No. of Applicants : 80

▶ Correct Answer : 31/80,  38.8%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - , Japan SUZUNE TSUKAMOTO
  • - The University of Tokyo Hospital , Japan MASAFUMI KAIUME
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Kyoto University , Japan AKIHIKO SAKATA
  • - Oita university , Japan AYUMI KAMEI
  • - , Italy PAOLO BALDASSARI
  • - Healthy Longevity Medical Center , Japan SHIN-ICHI CHO
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) SEONGSU KANG
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - Beaulieu clinic Geneva , Switzerland GILLES GENIN
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - Osaka University , Japan AKINORI HATA
  • - Ajou University Hospital , Korea (South) HAEIN LEE
  • - Soonchunhyang University Hospital Bucheon , Korea (South) HYEJOO PARK
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Inje University Pusan Paik Hospital , Korea (South) JIYEON HAN
  • - Seoul National University Bundang Hospital , Korea (South) JOONHYUK LEE
  • - Gifu University Hospital , Japan Yo Kaneko
  • - Other , Korea (South) CHAEHUN LIM
  • - TB centre kasaragod. , India rikhy krishnan
  • - Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
  • - Kantou Rousai Hospital , Japan KAORU SUMIDA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Sotiria Hospital, Athens , Greece VASILIOS TZILAS
  • - , Japan YUMI MAEHARA
  • - Toyota Kosei Hospital , Japan YUKI HAYASHI
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - , Korea (South) JIN WOO YOON
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Correct Answer as Differential Diagnosis : 6/80,  7.5%
  • - medical scanning , Japan HIROAKI ARAKAWA
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Kyoto University , Japan SHO KOYASU
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - Fukuoka university , Japan KEISUKE SATO
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