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Manini C, Vezzini S, Conte A, Sciacca G, Infantino A, Santos-Pereira P, López JI. Revisiting Pulmonary Sclerosing Pneumocytoma. Clin Pract 2024; 14:1440-1450. [PMID: 39051310 PMCID: PMC11270357 DOI: 10.3390/clinpract14040116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/20/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024] Open
Abstract
Pulmonary sclerosing pneumocytoma (PSP) is a quite rare tumor outside Eastern countries. This rarity, together with a wide histological appearance, makes its correct identification a diagnostic challenge for pathologists under the microscope. Historically, PSP was considered a vascular-derived neoplasm (sclerosing hemangioma), but its immunohistochemical profile clearly supports its epithelial origin. No specific molecular fingerprint has been detected so far. This short narrative revisits the clinical, histological, immunohistochemical, and molecular aspects of this tumor, paying special attention to some controversial points still not well clarified, i.e., clinical aggressiveness and metastatic spread, multifocality, the supposed development of sarcomatoid change in a subset of cases, and tumor associations with lung adenocarcinoma and/or well-differentiated neuroendocrine hyperplasia/tumors. The specific diagnostic difficulties on fine-needle aspiration cytology/biopsy and perioperative frozen sections are also highlighted. Finally, a teaching case of tumor concurrence of lung adenocarcinoma, neuroendocrine lesions, and PSP, paradigmatic of tumor association in this context, is also presented.
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Affiliation(s)
- Claudia Manini
- Department of Pathology, San Giovanni Bosco Hospital, ASL Città di Torino, 10154 Turin, Italy; (C.M.); (P.S.-P.)
- Department of Sciences of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Simone Vezzini
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.V.); (A.C.); (G.S.)
| | - Antonella Conte
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.V.); (A.C.); (G.S.)
| | - Giuseppe Sciacca
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (S.V.); (A.C.); (G.S.)
| | - Alessandro Infantino
- Faculty of Medicine and Dentistry, University of Rome “La Sapienza”, 00185 Rome, Italy;
| | - Poliana Santos-Pereira
- Department of Pathology, San Giovanni Bosco Hospital, ASL Città di Torino, 10154 Turin, Italy; (C.M.); (P.S.-P.)
| | - José I. López
- Biobizkaia Health Research Institute, 48903 Barakaldo, Spain
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Toro Soto PA, Rivero de Jesús É, Arenas Jiménez J, Aranda López FI. Sclerosing pneumocytoma with carcinoid tumorlets and neuroendocrine cell hyperplasia. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2022; 55 Suppl 1:S44-S48. [PMID: 36075662 DOI: 10.1016/j.patol.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/06/2020] [Accepted: 02/24/2020] [Indexed: 06/15/2023]
Abstract
Sclerosing pneumocytoma is an uncommon pulmonary tumor which generally behaves benignly and occurs predominately in women. Rarely, it is associated with neuroendocrine proliferations such as hyperplasia, tumorlets and carcinoid tumors, which may be observed in relation to the tumor or in the distant lung parenchyma; the mechanism underlying this neuroendocrine differentiation is not clear. We present a case of a 33 year-old male with sclerosing pnemocytoma with coexistent neuroendocrine hyperplasia and combined carcinoid tumorlets. Taking into account the pluripotentiality of the round cells present in the sclerosing pneumocytoma, with positive staining for stem cells markers, it is possible that the different components of this neoplasia share a common origin, in accordance with previously reported findings.
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Mlika M, Rais A, Abdelkbir A, Saad SB, Abdennadher M, Baccouche I, El Mezni F. Collision lung tumor associating typical carcinoid tumor to sclerosing hemangioma. Clin Case Rep 2022; 10:e6237. [PMID: 35957793 PMCID: PMC9361798 DOI: 10.1002/ccr3.6237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 07/06/2022] [Accepted: 07/25/2022] [Indexed: 11/06/2022] Open
Abstract
Collision tumors associating carcinoid tumor and sclerosing pneumocytoma have rarely been reported in the literature. The clinical presentation may be challenging especially in cases showing multiple and bilateral nodules. This case illustrates the association of both tumors diagnosed incidentally and illustrates a full spectrum of neuroendocrine lesions and sclerosing pneumocytoma. The authors present the case of a 52-year-old patient presenting an abdominal pain revealing a vesicular lithiasis and multiple pulmonary nodules. Radiologic follow-up of the asymptomatic lung lesions revealed the stabilization of a left lobe lesion with a disappearance of the other lesions. A lobectomy with a mediastinal lymph node curettage was performed. The microscopic examination revealed both tumor components associating a typical carcinoid tumor to a sclerosing pneumocytoma in association to lesions of diffuse neuroendocrine hyperplasia present in the peri-tumoral parenchyma. This case illustrates radiologic, gross, and microscopic features of a rare pulmonary tumor.
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Affiliation(s)
- Mona Mlika
- Department of PathologyAbderrahman Mami HospitalArianaTunisia
- Laboratory Research: LR18SP06TunisTunisia
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Abir Rais
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
| | - Amina Abdelkbir
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
- Department of Thoracic SurgeryAbderrahman Mami HospitalArianaTunisia
| | - Soumeya Ben Saad
- Laboratory Research: LR18SP06TunisTunisia
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
- Department C of PulmonologyAbderrahman Mami HospitalArianaTunisia
| | - Mahdi Abdennadher
- Laboratory Research: LR18SP06TunisTunisia
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
- Department of Thoracic SurgeryAbderrahman Mami HospitalArianaTunisia
| | - Ines Baccouche
- Department of RadiologyAbderrahman Mami HospitalArianaTunisia
| | - Faouzi El Mezni
- Department of PathologyAbderrahman Mami HospitalArianaTunisia
- Laboratory Research: LR18SP06TunisTunisia
- Faculty of Medicine of TunisUniversity Tunis El ManarTunisTunisia
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Sclerosing Pneumocytoma: A Host for a Typical Carcinoid With Pleural Metastasis-A Wolf in Sheep`s Clothing. Chest 2021; 159:e1-e5. [PMID: 33422233 DOI: 10.1016/j.chest.2020.06.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/25/2020] [Accepted: 06/25/2020] [Indexed: 12/27/2022] Open
Abstract
Sclerosing pneumocytoma (SP) is a rare primary lung tumor. Typical carcinoids (TCs) count for 2% of lung malignancies. A description of a combined neoplasm of SP with a nodal and pleural metastasized TC has, to our knowledge, never been published. A 57-year-old actively smoking woman received a diagnosis of a lesion in the left lower lobe via a screening CT scan for rheumatoid arthritis. A fluorodeoxyglucose-PET scan confirmed a 21 × 26 × 16 mm (standardized uptake maximum value, 3.0), well-circumscribed round lesion with calcification, which was thought to be most probably benign. No mediastinal lymph node enlargement or fluorodeoxyglucose uptake was detected. The results of routine laboratory tests, respiratory function tests, and physical examination were unremarkable. In diagnostic thoracoscopy pleural, diaphragmatic, and pericardial lesions were discovered and biopsied in addition to a wedge resection. After diagnosis of a pleural metastasized TC mixed with SP, radical resection and systemic lymph node dissection were performed. The patient is in remission after 36 months of follow-up.
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Cai L, Wang T, Jiang L, Yang P, Hu J, Jiang J. Sclerosing pneumocytoma mixed with a columnar clear cell adenoma and a typical carcinoid: case report and review of literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2020; 13:2599-2607. [PMID: 33165428 PMCID: PMC7642712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/07/2020] [Indexed: 06/11/2023]
Abstract
Sclerosing pneumocytoma (SP) is a rare and benign tumor predominantly occurring in Asian women, easily misdiagnosed by imaging and pathologic frozen diagnosis during surgery because of its diverse histomorphology (4 structures, 2 types of cells). It may form multiple tumors. When SP is combined with carcinoid, adenoma, or other tumors (although rare), diagnosis is more complicated. SP mixed with carcinoid tumor is rare. At present, only 4 cases have been reported in English literature. Here, we report a case of sclerosing pneumocytoma combined not only with carcinoid, but also with clear cell adenoma of the lung. The patient was a 52-year-old female and CT found a nodule in the middle lobe of the right lung. SP was not excluded by intraoperative frozen section diagnosis. The above 3 components formed a 1.4 cm nodule. The related literature is reviewed to strengthen the understanding of SP, and aid clinicopathological diagnosis.
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Affiliation(s)
- Li Cai
- Department of Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University No. 20 East Yuhuangding Road, Yantai, Shandong, China
| | - Ting Wang
- Department of Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University No. 20 East Yuhuangding Road, Yantai, Shandong, China
| | - Lei Jiang
- Department of Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University No. 20 East Yuhuangding Road, Yantai, Shandong, China
| | - Ping Yang
- Department of Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University No. 20 East Yuhuangding Road, Yantai, Shandong, China
| | - Jinchen Hu
- Department of Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University No. 20 East Yuhuangding Road, Yantai, Shandong, China
| | - Jing Jiang
- Department of Medicine, The Affiliated Yantai Yuhuangding Hospital of Qingdao University No. 20 East Yuhuangding Road, Yantai, Shandong, China
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Morikawa K, Misumi S, Fukuda T, Ojiri H, Matsudaira H, Sato S. Pulmonary sclerosing pneumocytoma presenting as slow-growing multiple nodules over a long period. Radiol Case Rep 2019; 14:602-607. [PMID: 30891111 PMCID: PMC6407144 DOI: 10.1016/j.radcr.2019.02.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/20/2019] [Accepted: 02/23/2019] [Indexed: 11/19/2022] Open
Abstract
Pulmonary sclerosing pneumocytoma is an uncommon slow-growing benign tumor that usually occurs in middle-aged women and generally presents as a solitary well-defined nodule. An 18-year-old woman was incidentally detected to have multiple lung nodules on chest radiography that slowly increased in size over a period of 7 years. Computed tomography images showed multiple well-defined nodules surrounded by numerous smaller nodules with a maximum diameter of 3 cm in the left lung. A percutaneous core needle biopsy was performed, but malignancy could not be excluded because of the high proportion of papillary structures. A video-assisted partial wedge resection was performed and the pathologic diagnosis was pulmonary sclerosing pneumocytoma. Pulmonary sclerosing pneumocytoma presenting as multiple lung nodules is a rare but very important condition to include in the differential diagnosis of multiple lung nodules. There is a possibility of misdiagnosis of another type of tumor or malignancy on preoperative biopsy. We should be aware not only of the clinical, radiologic, and pathologic features of pulmonary sclerosing pneumocytoma but also of the potential pitfalls in its diagnosis and management.
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Affiliation(s)
- Kazuhiko Morikawa
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shigeki Misumi
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Taiki Fukuda
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideki Matsudaira
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shun Sato
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
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Wang Z, Yang MQ, Huang WJ, Zhang D, Xu HT. Sclerosing pneumocytoma mixed with a typical carcinoid tumor: A case report and review of literature. Medicine (Baltimore) 2019; 98:e14315. [PMID: 30702609 PMCID: PMC6380861 DOI: 10.1097/md.0000000000014315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
RATIONALE Sclerosing pneumocytoma accompanied with other type of tumor in one patient is very rare. Here, we report a case of a sclerosing pneumocytoma mixed with a typical carcinoid tumor in a same neoplasm. PATIENT CONCERNS A 55-year-old woman incidentally detected a space-occupying lesion of right lung in routine health examination. The patient was asymptomatic and there were no positive findings in routine laboratory examination, physical examination, and pulmonary function test. Computed tomography revealed a solitary round mass in the middle lobe of the right lung. DIAGNOSIS The lesion was diagnosed as a sclerosing pneumocytoma accompanied with a typical carcinoid tumor of the right lung. INTERVENTION The patient underwent thoracoscopic lobectomy in our hospital. OUTCOMES The postoperative course was uneventful. LESSONS This case is rare and noteworthy for a lesion containing two different types of neoplasms, which may cause diagnostic difficulties.
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Affiliation(s)
- Zhao Wang
- Department of Pathology, the First Hospital and College of Basic Medical Sciences of China Medical University, Shenyang
- Department of Pathology, General Hospital of Heilongjiang Land Reclamation Bureau, Harbin
| | - Mai-Qing Yang
- Department of Pathology, the First Hospital and College of Basic Medical Sciences of China Medical University, Shenyang
- Department of Pathology, Changyi People's Hospital, Changyi, China
| | - Wen-Jing Huang
- Department of Pathology, the First Hospital and College of Basic Medical Sciences of China Medical University, Shenyang
| | - Di Zhang
- Department of Pathology, the First Hospital and College of Basic Medical Sciences of China Medical University, Shenyang
| | - Hong-Tao Xu
- Department of Pathology, the First Hospital and College of Basic Medical Sciences of China Medical University, Shenyang
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