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Kampolis CF, Damaskos C, Loukeri AA, Garmpis N, Garmpi A, Tomos I, Spartalis E, Dimitroulis D, Patsouras A, Douskou M, Papiris SA, Tomos P. Primary Hemangiopericytoma Arising in Extralobar Pulmonary Sequestration: A Coincidence or Two Rare Disorders? In Vivo 2020; 33:2141-2145. [PMID: 31662549 DOI: 10.21873/invivo.11715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND/AIM Extralobar pulmonary sequestration (EPS) is an unusual congenital defect characterized by the presence of non-functioning lung tissue receiving arterial supply from the systemic arteries. Primary hemangiopericytoma (HPC) is an uncommon potentially malignant tumor of vascular origin that usually involves the soft tissue of the extremities or retroperitoneum, but extremely rarely affects the lung. We present the rare case of a primary pulmonary HPC arising in an EPS. CASE REPORT A 65-year-old woman, with dyspnea and pleuritic chest pain, was referred for further investigation. Radiological evaluation demonstrated a well-circumscribed mass above the right hemidiaphragm, receiving its arterial supply from the descending thoracic aorta. The patient underwent a right posterolateral thoracotomy and a middle lobectomy. The intraoperative finding was a well-encapsulated solid mass. The histological evaluation described HPC. RESULTS The patient remains fit and healthy. CONCLUSION Pulmonary HPC can arise in EPS. Surgical excision is the treatment of choice.
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Affiliation(s)
- Christos F Kampolis
- Department of Pathophysiology, University of Athens, Medical School, Athens, Greece
| | - Christos Damaskos
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Angeliki A Loukeri
- Respiratory Care Unit, Sotiria Hospital, General Hospital of Chest Diseases, Athens, Greece
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Tomos
- Second Pulmonary Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Spartalis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Spyros A Papiris
- Second Pulmonary Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Periklis Tomos
- Department of Thoracic Surgery, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Chaidari, Greece
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2
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Hernández Pérez JM, Pérez Negrín L, López Charry CV. Primary Pulmonary Hemangiopericytoma. Arch Bronconeumol 2019; 55:593-594. [PMID: 31113667 DOI: 10.1016/j.arbres.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/07/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Affiliation(s)
- José María Hernández Pérez
- Sección de Neumología, Hospital General de La Palma, Breña Alta, La Palma, Santa Cruz de Tenerife, España.
| | - Lorenzo Pérez Negrín
- Servicio de Neumología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
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3
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Foran P, Colleran G, Madewell J, O'Sullivan PJ. Imaging of Thoracic Sarcomas of the Chest Wall, Pleura, and Lung. Semin Ultrasound CT MR 2011; 32:365-76. [DOI: 10.1053/j.sult.2011.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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4
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Ueno M, Nakashima O, Mishima M, Yamada M, Kikuno M, Nasu K, Kudo S. Pulmonary glomus tumor: CT and MRI findings. J Thorac Imaging 2004; 19:131-4. [PMID: 15071335 DOI: 10.1097/00005382-200404000-00015] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Pulmonary glomus tumor is rare and its manifestations on magnetic resonance imaging (MRI) have not, to our knowledge, been reported previously. A round mass was detected in the right upper lung field on a routine chest radiograph. With dynamic contrast-enhanced MRI, the mass showed strong, early-phase peripheral enhancement that expanded in a centripetal direction with time. Postoperative pathologic examination confirmed the diagnosis of glomus tumor.
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Affiliation(s)
- Masako Ueno
- Department of Radiology, Takagi Hospital, Okawa City, Fukuoka, Japan.
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5
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Lee KH, Song KS, Kwon Y, Lee I, Lee JS, Lim TH. Mesenchymal Tumours of the Thorax:CT Findings and Pathological Features. Clin Radiol 2003; 58:934-44. [PMID: 14654025 DOI: 10.1016/s0009-9260(03)00292-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mesenchymal tumours of the thorax are uncommon and may originate from the muscle, bone, cartilage, vessel, nerves, fat and fibrous tissue. These tumours occur at different sites including the lung, pleura, mediastinum or chest wall. Mesenchymal tumours tend to show protean and non-specific imaging characteristics. However, in some instances, the imaging characteristics of the tumour may allow a specific diagnosis to be made, such as with lipoid or vascular tumours.
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MESH Headings
- Adolescent
- Adult
- Female
- Humans
- Male
- Middle Aged
- Neoplasms, Adipose Tissue/diagnostic imaging
- Neoplasms, Adipose Tissue/pathology
- Neoplasms, Connective and Soft Tissue/diagnostic imaging
- Neoplasms, Connective and Soft Tissue/pathology
- Neoplasms, Fibrous Tissue/diagnostic imaging
- Neoplasms, Fibrous Tissue/pathology
- Neoplasms, Muscle Tissue/diagnostic imaging
- Neoplasms, Muscle Tissue/pathology
- Neoplasms, Vascular Tissue/diagnostic imaging
- Neoplasms, Vascular Tissue/pathology
- Thoracic Neoplasms/diagnostic imaging
- Thoracic Neoplasms/pathology
- Tomography, X-Ray Computed/methods
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Affiliation(s)
- K-H Lee
- Department of Radiology, Inha University Hospital, Shinheung-dong, Joong-gu, Inchon, South Korea
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6
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Yilmaz E, Akkoclu A, Kargi A, Sevinc C, Komus N, Catalyurek H, Acikel U. Radiography, Doppler sonography, and MR angiography of malignant pulmonary hemangiopericytoma. AJR Am J Roentgenol 2003; 181:1079-81. [PMID: 14500234 DOI: 10.2214/ajr.181.4.1811079] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Erkan Yilmaz
- Department of Radiology, Dokuz Eylül University School of Medicine, TR-35330 Balcova, 35340 Izmir, Turkey
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7
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Said M, Migaw H, Hafsa C, Braham R, Golli M, Moussa A, Zakhama A, Elkamel A, Gannouni A. Imaging features of primary pulmonary liposarcoma. AUSTRALASIAN RADIOLOGY 2003; 47:313-7. [PMID: 12890257 DOI: 10.1046/j.1440-1673.2003.01198.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Primary liposarcoma of the lung is extremely rare. We report a 28-year-old pregnant woman who complained of dyspnoea during the third trimester. Chest radiography, thoracic ultrasound, CT and MRI showed a huge heterogeneous tumour involving all the left lung and the mediastinum. The tumour was composed of soft tissue, and fatty and cystic components with calcifications. Diagnosis was made on core biopsy under CT guidance. Surgical excision was performed but unfortunately the patient died during the operation.
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Affiliation(s)
- Mourad Said
- Department of Diagnostic Radiology, Universitary Hospital of Monastir, Tunisia.
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8
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Yoon YC, Lee KS, Kim TS, Seo JB, Han J. Benign bronchopulmonary tumors: radiologic and pathologic findings. J Comput Assist Tomogr 2002; 26:784-96. [PMID: 12439315 DOI: 10.1097/00004728-200209000-00020] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
According to the new World Health Organization classification, benign bronchopulmonary tumors can be classified into epithelial tumors, mesenchymal tumors, and tumor-like conditions. Imaging findings of benign tumors of large airways are nonspecific and overlapping. Some benign pulmonary tumors show characteristic imaging findings. On CT, bronchioloalveolar adenomas appear as a small nodular area of ground-glass opacity. Metastasizing leiomyomas are seen as well-circumscribed solitary or multiple pulmonary nodules ranging in size from a few millimeters to several centimeters. Pulmonary hamartomas or lipomas are recognized specifically when fat deposits of CT number in the -80 HU to -120 HU range are identified. Enhancement of tumor with administration of contrast medium with or without foci of calcification may be seen in sclerosing hemangiomas and hemangiopericytomas. Awareness of the various imaging findings of these tumors can help narrow down the differential diagnosis on daily practice among the long lists of bronchopulmonary tumors.
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Affiliation(s)
- Young Cheol Yoon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
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Engelke C, Schaefer-Prokop C, Schirg E, Freihorst J, Grubnic S, Prokop M. High-resolution CT and CT angiography of peripheral pulmonary vascular disorders. Radiographics 2002; 22:739-64. [PMID: 12110707 DOI: 10.1148/radiographics.22.4.g02jl01739] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Peripheral pulmonary vascular disorders that can be evaluated with computed tomography (CT) include various disease entities with overlapping imaging features and a wide range of clinical manifestations. The overall accuracy of CT in the diagnosis of pulmonary vascular disorders increases with improved spatial resolution, administration of a high-flow contrast material bolus, and the use of cardiac gating. The integration of high-resolution CT and CT angiographic techniques into one scanning protocol has important clinical implications for multisection CT and makes it the imaging modality of choice in the evaluation of this complex group of disorders.
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10
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Giménez A, Franquet T, Prats R, Estrada P, Villalba J, Bagué S. Unusual primary lung tumors: a radiologic-pathologic overview. Radiographics 2002; 22:601-19. [PMID: 12006690 DOI: 10.1148/radiographics.22.3.g02ma25601] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although the great majority of lung carcinomas are histologically characterized as adenocarcinoma, squamous cell carcinoma, large cell undifferentiated carcinoma, or small cell carcinoma, a variety of rare benign and malignant lung tumors may sporadically affect the lung. Several nonneoplastic tumorlike lesions are seen infrequently but are also part of the differential diagnosis for lung masses. Conventional radiographic findings, although of limited value in the diagnosis of these entities, should be examined carefully when lung tumors are suspected. Computed tomography (CT) is well suited for making a definitive diagnosis of some disease processes. CT helps determine the location and features of the lesions and depicts associated findings to help document the extent of disease. The differential diagnosis can be narrowed when there are typical CT features (eg, the presence of fat in lipoid pneumonia). Although unusual primary lung tumors are difficult to diagnose on the basis of imaging findings alone because such findings are nonspecific in the majority of cases, cross-sectional imaging can play an important role in the diagnostic work-up of these unusual tumors by delineating their extent and directing the radiologist or bronchoscopist to the appropriate biopsy site.
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Affiliation(s)
- Ana Giménez
- Department of Radiology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni M. Claret 167, 08025 Barcelona, Spain.
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11
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Ravenel JG, Goodman PC. Late pulmonary metastases from hemangiopericytoma of the mandible: unusual findings on CT and MR imaging. AJR Am J Roentgenol 2001; 177:244-5. [PMID: 11418437 DOI: 10.2214/ajr.177.1.1770244] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- J G Ravenel
- Department of Radiology, Box 3808, Duke University Medical Center, Durham, NC 27710, USA
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12
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Porte HL, Metois DG, Leroy X, Conti M, Gosselin B, Wurtz A. Surgical treatment of primary sarcoma of the lung. Eur J Cardiothorac Surg 2000; 18:136-42. [PMID: 10925220 DOI: 10.1016/s1010-7940(00)00465-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To study the results of surgical treatment of primary lung sarcoma. METHODS Between 1982 and 1998, we performed 18 macroscopically complete resections for primary sarcomas of the lung. The records of all patients were reviewed, as were pathological slides. Presence of symptoms, tumour size (more or less than 5 cm), complete resection, TNM stage and histology grade were analyzed for predictors of survival. RESULTS Patients comprised 11 women and seven men whose age ranged from 19 to 73 years (mean 50 years). Mean tumour diameter was 8.05 cm (range 2.5-15 cm) There were one grade 1, eight grade 2 and nine grade 3 tumours. Tumours in two patients were unresectable at first presentation, and another was of doubtful resectability according to computed tomography scan. These three patients received pre-operative chemotherapy, with a partial response in the two unresectable patients allowing macroscopically complete resection in both cases. We performed 12 lobectomies (extended to the chest wall in two cases and to the diaphragm in two cases) and six pneumonectomies (extended to the chest wall in one case and the superior vena cava in one case). Operative and 30 days post-operative mortality were nil. Resection margins were invaded in two cases. Six patients received post-operative chemo- or radiotherapy and three others underwent repeat resections for pulmonary sarcoma recurrence. No patients were lost to follow-up. Pulmonary sarcomas recurred in eight patients (44%) leading to death in five cases after a mean period of 17 months. Overall median survival was 48 months, and actuarial 5-year survival 43%. Only TNM stage correlated with significantly increased survival. CONCLUSION As complete resection is the best therapeutic option for obtaining an acceptable survival rate in primary pulmonary sarcoma, pre-operative chemotherapy can be a useful adjunct in increasing the resectability of these tumours.
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Affiliation(s)
- H L Porte
- Department of Thoracic Surgery, Lille University Hospital, Hôpital Calmette, 1 Rue du Professeur J. Leclercq, 59037 Cédex, Lille, France.
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13
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Abstract
A primary malignant pulmonary hemangiopericytoma was diagnosed in a 45-year-old woman who complained of 10 months of cough and exertional dyspnea. One year after resection of the mass, a metastatic lesion was removed from the contralateral lung. The literature on this unusual pulmonary lesion is reviewed.
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Affiliation(s)
- D S Katz
- Department of Radiology, Winthrop University Hospital, Mineola, NY 11501, USA
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14
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Flores-Stadler EM, Chou P, Walterhouse D, Bourtsos E, Gonzalez-Crussi F. Hemangiopericytoma of the liver: immunohistochemical observations, expression of angiogenic factors, and review of the literature. J Pediatr Hematol Oncol 1997; 19:449-54. [PMID: 9329468 DOI: 10.1097/00043426-199709000-00008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE We describe an unusual case of a hemangiopericytoma in the liver of a child, review the literature, and characterize the tumor by immunohistochemistry and electron microscopy. We study the expression of basic fibroblast growth factor (bFGF) and of vascular endothelial growth factor (VEGF) in the tumor. MATERIALS AND METHODS Clinical history and pathology were reviewed; sections of the tumor were studied by histology, electron microscopy, and immunohistochemistry using antibodies directed towards factor-XIIIa, HAM-56, bFGF and VEGF, among others. RESULTS The expression of VEGF resembled that of "proliferating" hemangiomas; however, despite being markedly elevated in the urine, bFGF could not be unequivocally detected in the tumor. A subpopulation of factor XIIIa positive cells was identified, similar to the "interstitial" cells of the cellular hemangiomas of infancy. The nature and function of these cells remains speculative. CONCLUSIONS Hemangiopericytomas are rare in the liver. When arising in this location in a child, they may clinically resemble a hemangioma, may express angiogenic factors in a similar fashion, and should be considered in the differential diagnosis.
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Affiliation(s)
- E M Flores-Stadler
- Department of Pathology, Children's Memorial Hospital, Chicago, IL 60614-3394, USA
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