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Zhang Y, Ran C, Li W. Central and peripheral pulmonary sclerosing pneumocytomas: multi-phase CT study and comparison with Ki-67. Radiol Oncol 2023; 57:310-316. [PMID: 37665739 PMCID: PMC10476905 DOI: 10.2478/raon-2023-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/21/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the multi-phase CT findings of central and peripheral pulmonary sclerosing pneumocytomas (PSPs) and compared them with Ki-67 to reveal their neoplastic nature. PATIENTS AND METHODS Multi-phase CT and clinical data of 33 PSPs (15 central PSPs and 18 peripheral PSPs) were retrospectively analyzed and compared their multi-phase CT features and Ki-67 levels. RESULTS For quantitative indicators, central PSPs were larger than peripheral PSPs (10.39 ± 3.25 cm3 vs. 4.65 ± 2.61 cm3, P = 0.013), and tumor size was negatively correlated with acceleration index (r = -0.845, P < 0.001). The peak enhancement of central PSPs appeared in the delayed phase, with a longer time to peak enhancement (TTP, 100.81 ± 19.01 s), lower acceleration index (0.63 ± 0.17), progressive enhancement, and higher Ki-67 level. The peak enhancement of peripheral PSPs appeared in the venous phase, with the shorter TTP (62.67 ± 20.96 s, P < 0.001), higher acceleration index (0.99 ± 0.25, P < 0.001), enhancement washout, and lower Ki-67 level. For qualitative indicators, the overlying vessel sign (86.67% vs. 44.44%, P = 0.027), prominent pulmonary artery sign (73.33% vs. 27.78%, P = 0.015), and obstructive inflammation/atelectasis (26.67% vs. 0%, P = 0.033) were more common in central PSPs, while peripheral PSPs were more common with halo sign (38.89% vs. 6.67%, P = 0.046). CONCLUSIONS The location of PSP is a possible contributing factor to its diverse imaging-pathological findings. The tumor size, multi-phase enhancement, qualitative signs, and Ki-67 were different between central and peripheral PSPs. Combined tumor size, multi-phase findings, and Ki-67 level are helpful to reveal the nature of the borderline tumor.
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Affiliation(s)
- Yanli Zhang
- Department of Clinical Pharmacy, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Chao Ran
- Department of Radiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Wei Li
- Department of Medical Imaging, Affiliated Hospital of Yangzhou University, Yangzhou, China
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Kim SJ, Kang HR, Lee CG, Choi SH, Kim YW, Lee HW, Lee CH. Pulmonary sclerosing pneumocytoma and mortality risk. BMC Pulm Med 2022; 22:404. [DOI: 10.1186/s12890-022-02199-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/05/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
Surgical resection is usually recommended for the treatment of pulmonary sclerosing pneumocytoma (PSP). However, no comparative study has demonstrated that surgical resection leads to improved outcomes. We aimed to compare all-cause mortality between patients with PSP who underwent surgery or did not and those without PSP.
Methods
Participants aged ≥18 years who had pathologically diagnosed PSP between 2001 to 2018, at 3 hospitals were included. Randomly selected (up to 1:5) age-, sex-, and smoking status-matched controls without PSP who were randomly selected from those who underwent health checkups including chest CT were included. Mortality was compared using Kaplan–Meier estimates and Cox proportional hazards regression models. Literature review of studies reporting PSP was also conducted.
Results
This study included 107 patients with PSP (surgery:non-surgery, 80:27) and 520 matched controls. There were no cases of lymph node or distant metastasis, recurrence, or mortality from PSP. No significant difference in all-cause mortality risk was observed between the PSP surgery, PSP non-surgery, and non-PSP groups (log rank test P = 0.78) (PSP surgery vs. non-PSP: adjusted hazards ratio [aHR], 1.80; 95% confidence interval [CI], 0.22–14.6; PSP non-surgery vs. non-PSP: aHR, 0.77; 95% CI, 0.15–3.86; PSP surgery vs. PSP non-surgery: aHR, 2.35; 95% CI, 0.20–28.2). In the literature review, we identified 3469 patients with PSP from 355 studies. Only 1.33% of these patients reported metastasis, recurrence, or death.
Conclusions
All-cause mortality did not differ between patients with PSP and those without, irrespective of undergoing surgery. Our study and the literature review suggest that PSP has less impact on increased mortality risk.
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Treatment and post-operative follow-up of pulmonary sclerosing pneumocytoma: A case report. Ann Med Surg (Lond) 2022; 84:104836. [PMID: 36582872 PMCID: PMC9793125 DOI: 10.1016/j.amsu.2022.104836] [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: 08/18/2022] [Revised: 09/22/2022] [Accepted: 10/30/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction and importance Pulmonary sclerosing pneumocytoma (PSP) is a rare tumor thought to originate from respiratory epithelial cells. It is usually benign, but may rarely metastasize to lymph nodes. Surgeons face unique challenges in diagnosis and management of this condition, and ideal surgical management is yet to be established. Case presentation 48-year-old woman with a 7 × 7 mm pulmonary lesion discovered incidentally on computerized tomography (CT) imaging, which grew to 9 mm over the following year. Seven years later, follow-up imaging revealed that the mass had grown to 1.3 cm in largest dimension. Surgery was recommended and the mass was resected via a right video-assisted thoracic surgery (VATS) middle lobectomy with mediastinal lymph node dissection. All lymph nodes were negative and the patient's postoperative course was unremarkable. Clinical discussion There are few evidence-based guidelines available on the treatment and postoperative surveillance of PSP. Research has shown comparable recurrence-free survival rates for sublobar resection and lobectomy, though recurrence can occur, especially following sublobar resection in larger or more centrally-located tumors. In absence of established guidelines, it was decided to follow this patient according to NCCN guidelines for surveillance of early-stage non-small cell lung cancer due to potential risk of recurrence. Conclusion This case report adds to the limited literature on PSP and depicts a possible treatment and postoperative follow-up plan. Right VATS middle lobectomy can effectively treat some cases of central PSP. In absence of established guidelines for postoperative follow-up of PSP, NCCN guidelines may outline one possible strategy for postoperative management.
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Pulmonary sclerosing pneumocytoma: clinical features and prognosis. World J Surg Oncol 2022; 20:140. [PMID: 35490241 PMCID: PMC9055737 DOI: 10.1186/s12957-022-02603-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Pulmonary sclerosing pneumocytoma is a kind of rare benign pulmonary tumor with potential malignancy. The clinical features, risk factors for prognosis, and optimal treatment have not been identified yet. This study aimed to investigate the clinical features and prognosis of pulmonary sclerosing pneumocytoma. METHODS We retrospectively performed a review of pulmonary sclerosing pneumocytoma patients in West China Hospital from 2009 to 2019. The basic characteristics, treatment regimens, operation detail, postoperative variables, and follow-up time were recorded for each case. Differences in features between patients undergoing lobectomy and segmentectomy were compared. We also performed a case review and summarized reported clinical features in former studies. RESULTS Altogether 61 pulmonary sclerosing pneumocytoma patients were retrospectively reviewed. Fifty-six patients were female and 5 were male. The patients' median age was 51 (23-73). Seven (11.48%) patients had smoking history. Twenty tumors were located in the right lung [upper lobe (n = 7), middle (n = 2), and lower (n = 11)] and 41 in the left [upper (n = 12) and lower (n = 29)]. The median tumor size was 2 (0.9-7) cm. Thirty-six (59.02%) patients underwent sublobectomy (segmentectomy or wedge resection) whereas 25 (40.98%) underwent lobectomy. All patients recovered uneventfully, and no perioperative mortality was identified. Sublobectomy showed a trend towards reduced chest tube duration and shorter postoperative hospital stays compared with lobectomy. CONCLUSIONS The findings showed good prognosis of pulmonary sclerosing pneumocytoma and proved its benign characteristics. Sublobectomy showed advanced efficacy regarding chest tube duration and postoperative hospital stay compared with lobectomy.
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David N, Chandy ST, Benjamin SR, Mohammad A, Mallampati S, Kodiatte TA, Gnanamuthu BR. Pulmonary sclerosing pneumocytoma-a case series. Indian J Thorac Cardiovasc Surg 2022; 38:167-172. [PMID: 35221554 PMCID: PMC8857380 DOI: 10.1007/s12055-021-01269-z] [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: 06/30/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 10/19/2022] Open
Abstract
Pulmonary sclerosing pneumocytoma (PSP) is a rare and interesting pulmonary tumour that presents a diagnostic challenge to the surgeon due to its bland symptomatology, indolent course, non-specific radiological features and ambiguous histopathological findings, which could lead to errors in management and prognostication. Herein, we present a series of 4 patients with PSP who were managed in our institution over a period of 8 years and briefly discuss relevant literature.
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Affiliation(s)
- Nishok David
- grid.11586.3b0000 0004 1767 8969The Department of Cardiothoracic Surgery, The Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Sujith Thomas Chandy
- grid.11586.3b0000 0004 1767 8969The Department of Pulmonary Medicine, The Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Santhosh Regini Benjamin
- grid.11586.3b0000 0004 1767 8969The Department of Cardiothoracic Surgery, The Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Aamir Mohammad
- grid.11586.3b0000 0004 1767 8969The Department of Cardiothoracic Surgery, The Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Sameer Mallampati
- grid.11586.3b0000 0004 1767 8969The Department of Cardiothoracic Surgery, The Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Thomas Alex Kodiatte
- grid.11586.3b0000 0004 1767 8969The Department of General Pathology, The Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Birla Roy Gnanamuthu
- grid.11586.3b0000 0004 1767 8969The Department of Cardiothoracic Surgery, The Christian Medical College, Vellore, Tamil Nadu 632004 India
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Abdelghaffar M, Mandeel F, Rabea Z, George S, Al Saeed M. Interlobar Pulmonary Hamartoma With an Unusual Neighboring Lesion: A Case Report. Cureus 2021; 13:e14008. [PMID: 33884249 PMCID: PMC8054229 DOI: 10.7759/cureus.14008] [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] [Indexed: 12/05/2022] Open
Abstract
Pulmonary hamartomas are benign lung tumors. They are uncommon and represent a small percentage of all solitary lung lesions. Hamartomas are composed of an abnormal mixture of epithelial and mesenchymal elements. They are usually discovered incidentally as patients are asymptomatic in most cases. On the other hand, sclerosing pneumocytomas are rarely discovered and are one of the most uncommon benign lung tumors. Herein, we present the case of a 37-year-old female who presented with hemoptysis. A computed tomography scan of her thorax revealed a right-sided round lesion in the interlobar fissure with no additional findings. Surgical excision was performed, which demonstrated an uncommon and unique finding of a pulmonary hamartoma coexisting with a sclerosing pneumocytoma found on exploration. This highlights the importance of exploration during surgical procedures in order identify missed lesions on imaging.
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Affiliation(s)
| | - Fatima Mandeel
- Internal Medicine, Salmaniya Medical Complex, Manama, BHR
| | - Zahraa Rabea
- Internal Medicine, Salmaniya Medical Complex, Manama, BHR
| | - Sara George
- Pathology and Laboratory Medicine, Salmaniya Medical Complex, Manama, BHR
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Chen J, Staziaki PV, Zheng H, Burks EJ, Meibom S, Litle VR, Natcheva HN. 68Ga-DOTATATE-avid pulmonary sclerosing pneumocytoma in a man of North African descent: Case report, imaging findings and pathology. Clin Imaging 2021; 77:175-179. [PMID: 33725576 DOI: 10.1016/j.clinimag.2021.02.028] [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: 11/13/2020] [Revised: 01/30/2021] [Accepted: 02/14/2021] [Indexed: 11/25/2022]
Abstract
Pulmonary sclerosing pneumocytoma (PSP) is a benign tumor originating from primitive respiratory epithelium which tends to present as an asymptomatic solitary lesion in the periphery of the lung. It primarily occurs in women, with a 5:1 ratio of female to male, and in East Asian populations. We describe a rare case of a gallium-68 (68Ga)-DOTATATE avid PSP in a middle-aged man of North African ancestry. Contrast-enhanced computed tomography (CT) revealed an enhancing ovoid 2-cm solid lesion within the periphery of the left upper lobe abutting the superior portion of the lateral left ventricular wall. A fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) demonstrated low-level FDG uptake, but a 68Ga-DOTATATE PET/CT showed avid tracer uptake, concerning for a carcinoid tumor. The lesion was surgically excised, and the histopathologic analysis revealed the typical morphologic and histochemical markers of a PSP. We conclude that, although rare, PSP can be a differential consideration when evaluating a 68Ga-DOTATATE-avid solitary lung nodule concerning for carcinoid tumor, in all genders and in ethnicities other than East Asian.
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Affiliation(s)
- Jefferson Chen
- Division of Cardiothoracic Imaging, Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, United States of America
| | - Pedro Vinícius Staziaki
- Division of Cardiothoracic Imaging, Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, United States of America.
| | - Hanqiao Zheng
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, United States of America.
| | - Eric J Burks
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, United States of America.
| | - Sara Meibom
- Division of Nuclear Medicine, Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, United States of America.
| | - Virginia R Litle
- Division of Thoracic Surgery, Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, United States of America.
| | - Hristina N Natcheva
- Division of Cardiothoracic Imaging, Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, United States of America
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8
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Boland JM, Lee HE, Barr Fritcher EG, Voss JS, Jessen E, Davila JI, Kipp BR, Graham RP, Maleszewski JJ, Yi ES. Molecular Genetic Landscape of Sclerosing Pneumocytomas. Am J Clin Pathol 2021; 155:397-404. [PMID: 33145590 DOI: 10.1093/ajcp/aqaa136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Sclerosing pneumocytomas are rare pulmonary neoplasms that are typically benign. However, rare patients experience progressive disease, and therapy targeting specific genetic underpinnings could be an attractive therapeutic option. Recent studies have found recurrent AKT 1 mutations in sclerosing pneumocytoma, but little is known about whether oncogenic fusion genes may also be present. METHODS To better understand the genetic background, 10 sclerosing pneumocytomas were subjected to next-generation sequencing cancer mutation panel testing (n = 9) and/or RNA sequencing (n = 3). The patients were all women (average age, 47 years; range, 17-74 years). RESULTS Eight patients had solitary sclerosing pneumocytomas, while one had two tumors, and one had many bilateral tumors. Recurrent mutations were noted in genes involved in the mTOR pathway, including AKT1, PIK3R1, and PTEN. AKT1 alterations were particularly common, present in 78%. No recurrent genetic fusions were identified. The patient in our study with multiple bilateral lesions was treated with the mammalian target of rapamycin (mTOR) inhibitor everolimus, with no objective radiographic evidence of treatment response after 4 months. CONCLUSIONS Our data further support that abnormal activation of the mTOR pathway is a consistent genetic event in sclerosing pneumocytoma. This warrants further exploration to determine if mTOR pathway inhibitors may be effective in patients with metastatic or recurrent disease.
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Affiliation(s)
- Jennifer M Boland
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Hee Eun Lee
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | - Jesse S Voss
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Erik Jessen
- Division of Biomedical Statistics and Informatics, Department of Research Services, Mayo Clinic, Rochester, MN
| | - Jaime I Davila
- Division of Biomedical Statistics and Informatics, Department of Research Services, Mayo Clinic, Rochester, MN
| | - Benjamin R Kipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Rondell P Graham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | - Eunhee S Yi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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Aramini B, Masciale V, Manfredini B, Bianchi D, Banchelli F, D'Amico R, Bertolini F, Dominici M, Morandi U, Maiorana A. Expression of ALDH and SOX-2 in Pulmonary Sclerosing Pnemocytoma (PSP) of the Lung: Is There a Meaning Behind? Front Med (Lausanne) 2020; 7:497. [PMID: 32984377 PMCID: PMC7492541 DOI: 10.3389/fmed.2020.00497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/20/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Pulmonary sclerosing pneumocytoma (PSP) is a rare benign pulmonary tumor that derives from primitive respiratory epithelium of the pulmonary alveolus. The etiology and pathogenesis are still unclear. Histopathological diagnosis focuses on cells that are positive for TTF1, EMA, cytokeratin-7, and CAM 5.2. The aim of our study is to highlight the elevated expression of ALDH and the presence of SOX-2 in pulmonary sclerosing pneumocytoma. Methods: We report five cases of pulmonary sclerosing pneumocytoma undergone surgery at our Division of Thoracic Surgery, during a period between 1994 and 2011. ALDH and SOX-2 markers were also tested for positivity in all the patients. Results: Patients showed elevated expression of ALDH during immunohistochemistry and mild expression of SOX-2, although in two cases in which SOX-2 was highly expressed. Among these two patients, one presented with lymph node recurrence while the other had no recurrence with a PET-positive nodule. In particular, the patient who had developed recurrence had an ALDH score of 4 and a SOX-2 score of 3, whereas the patient with the PET-positive nodule showed an ALDH score of 4 with a mild SOX-2 expression of score 1. Conclusions: This is the first attempt demonstrating the elevated expression of ALDH in this disease. SOX-2 expression was noted in both the patient who developed recurrence and the patient with a PET-positive nodule. We believe that further investigation may be highly useful to better characterize these two markers as well as understand their function.
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Affiliation(s)
- Beatrice Aramini
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Valentina Masciale
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Beatrice Manfredini
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniel Bianchi
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Federico Banchelli
- Department of Medical and Surgical Sciences, Center of Statistic, University of Modena and Reggio Emilia, Modena, Italy
| | - Roberto D'Amico
- Department of Medical and Surgical Sciences, Center of Statistic, University of Modena and Reggio Emilia, Modena, Italy
| | - Federica Bertolini
- Division of Oncology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Dominici
- Division of Oncology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Uliano Morandi
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonino Maiorana
- Department of Medical and Surgical Sciences, Institute of Pathology, University of Modena and Reggio Emilia, Modena, Italy
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Sakai T, Miyoshi T, Umemura S, Suzuki J, Nakasone S, Okada S, Tane K, Aokage K, Goto K, Motoi N, Ishii G, Tsuboi M. Large pulmonary sclerosing pneumocytoma with massive necrosis and vascular invasion: a case report. Oxf Med Case Reports 2019; 2019:5539001. [PMID: 31428771 PMCID: PMC6660061 DOI: 10.1093/omcr/omz066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 05/24/2019] [Accepted: 05/30/2019] [Indexed: 12/05/2022] Open
Abstract
Pulmonary sclerosing pneumocytoma (PSP) is pathologically classified as an adenoma and behaves in a benign manner. However, some cases of PSP displayed pathologically malignant behavior, such as lymph node metastasis and necrosis. A 64-year-old woman was referred to our hospital complaining of a cough and breathlessness. Histopathological analysis of the resected specimen by left pneumonectomy and lymph node dissection revealed a large PSP measuring 15 × 14 cm in size, with massive necrosis and vascular invasion. This case was the largest ever reported and suggested that clinico-histological presentation of PSP sometimes showed an aggressive phenotype like advanced lung cancer.
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Affiliation(s)
- Takashi Sakai
- Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.,Department of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan.,Division of Chest Surgery, Department of Surgery, Toho University Graduate School of Medicine, Ota, Tokyo, Japan
| | - Tomohiro Miyoshi
- Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Shigeki Umemura
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Jun Suzuki
- Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.,Department of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan
| | - Shoko Nakasone
- Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Satoshi Okada
- Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Kenta Tane
- Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Keiju Aokage
- Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Noriko Motoi
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Chuo, Tokyo, Japan
| | - Genichiro Ishii
- Department of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan
| | - Masahiro Tsuboi
- Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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Xu J, Dong Y, Yin G, Jiang W, Yang Z, Xu W, Zhu L. 18 F-FDG PET/CT imaging: A supplementary understanding of pulmonary sclerosing pneumocytoma. Thorac Cancer 2019; 10:1552-1560. [PMID: 31131992 PMCID: PMC6610286 DOI: 10.1111/1759-7714.13100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 11/28/2022] Open
Abstract
Background We sought to investigate the clinical features and 18F‐FDG PET/CT characteristics of pulmonary sclerosing pneumocytoma (PSP). Methods We retrospectively reviewed and comparatively analyzed 18F‐FDG PET/CT imaging results of 22 patients with diagnosed PSP in our hospital from November 2009 to September 2015. Results The SUVmax in tumors was positively correlated with tumor size in typical PSPs (R = 0.806, R2 = 0.650, P = 0.001); however, the SUVmax in tumors had no significant correlation with tumor size of atypical PSPs (R = 0.479, R2 = 0.229, P = 0.162), and the degree of correlation between them attenuated when atypical PSPs were included (R = 0.518, R2 = 0.268, P = 0.011). A majority (90%) of atypical PSPs were found in males. Symptomatic patients showed a higher SUVmax than the asymptomatic group (5.68 ± 3.63 vs. 2.76 ± 1.18, respectively, P = 0.002). Conclusion Tumor size and clinical features may be associated with increased FDG uptake in PSPs. Morphological differences may affect the correlation between tumor size and SUVmax in PSPs. The atypical form of PSP may be more common in men.
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Affiliation(s)
- Jie Xu
- Department of Senior Ward, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Youwen Dong
- Imaging Center, The Affiliated Hospital of Jining Medical University, Jining, China
| | - Guotao Yin
- Department of Molecular Imaging and Nuclear Medicine, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Wei Jiang
- Department of Molecular Imaging and Nuclear Medicine, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Zhen Yang
- Department of Molecular Imaging and Nuclear Medicine, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Wengui Xu
- Department of Molecular Imaging and Nuclear Medicine, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Lei Zhu
- Department of Molecular Imaging and Nuclear Medicine, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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13
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Sclerosing Pneumocytoma: A Ten-Year Experience at a Western Balkan University Hospital. ACTA ACUST UNITED AC 2019; 55:medicina55020027. [PMID: 30691016 PMCID: PMC6409643 DOI: 10.3390/medicina55020027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 12/02/2022]
Abstract
Background and objective: Sclerosing pneumocytoma is a rare, benign tumor of the lung that represents a diagnostic challenge due to the diversity of pathohistological findings. The aim of this study was to present a 10-year experience with sclerosing pneumocytoma of a large center for the diagnosis and treatment of pulmonary diseases, and to emphasize differential diagnostic dilemmas as a potential source of errors. Material and Methods: This represents a retrospective study of six patients diagnosed and treated with sclerosing pneumocytoma in the 10-year period. The study analyzed various parameters, which are: Sex, age, symptoms, size and localization of the tumor, and its gross and histological features. Results: Sclerosing pneumocytoma was more frequently diagnosed in females (83.34%). The patients ranged in age from 38 to 61. Most of the patients (66.66%) were asymptomatic. Two patients underwent a video-assisted thoracoscopic surgery, two patients had a video-assisted minithoracotomy, and two patients underwent a thoracotomy in order to remove the tumor. The tumor was localized in the left lower lobe, in the right upper lobe, and in the right lower lobe in 50%, 33.34%, and 16.66% of patients, respectively. The tumor size ranged from 1 to 2.5 cm. A pathohistological examination of all six cases reported that all four major histological patterns were found in tissue sections: solid, papillary, sclerosing, and hemorrhagic. In all six cases, an immunohistochemical analysis showed positive expression of TTF-1 and panCK in surface epithelial cells, and TTF-1 positivity and panCK negativity in round stromal cells. Conclusions: Sclerosing pneumocytoma is a strictly histological diagnosis supported by clinical and radiological findings and corresponding immunohistochemical methods. Lung pathologists should always keep this tumor in mind, since its spectrum of differential diagnosis is wide, and therefore it can be an important diagnostic pitfall.
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Jiang L, Huang Y, Tang Q, Zhao Q, Li Y, Wu X, Wang H. 18F-FDG PET/CT characteristics of pulmonary sclerosing hemangioma vs. pulmonary hamartoma. Oncol Lett 2018; 16:660-665. [PMID: 29930720 DOI: 10.3892/ol.2018.8660] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 04/12/2018] [Indexed: 11/05/2022] Open
Abstract
The radiological features of pulmonary sclerosing hemangioma (PSH) and pulmonary hamartoma are poorly specified. Thus, the present study aimed to compare and analyze the characteristics of fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in PSH versus pulmonary hamartoma. 18F-FDG PET/CT characteristic findings of 12 patients with PSH and 14 patients with pulmonary hamartoma were retrospectively reviewed. A total of 12 lesions were detected from the 12 patients with PSH, of which 3 masses exhibited calcification. The mean diameter and standardized maximum uptake value (SUVmax) were 1.9±0.7 cm and 2.6±1.0, respectively, and there was no significant correlation between the lesion size and SUVmax (P>0.05). For the 14 patients with pulmonary hamartoma, 14 lesions were found, of which 4 exhibited calcification. The mean diameter and SUVmax were 1.7±0.8 cm and 1.5±0.6, respectively, and there was a significant correlation between the size and SUVmax (r=0.625, r2=0.391, P<0.05). Although there was no significant difference between the size of PSH and pulmonary hamartoma (P>0.05), the SUVmax of PSH was significantly higher than that of pulmonary hamartoma (P<0.05). Moreover, the SUVmax of 1.95 was applied as a cutoff for the diagnosis of PSH, and the resulting sensitivity and specificity for PET/CT to differentiate PSH from pulmonary hamartoma were 83.3 and 78.6%, respectively. Although the morphological features were not specific, PSH showed significantly higher FDG accumulation than pulmonary hamartoma on PET/CT imaging, which may aid the differential diagnosis. Further studies with larger populations are warranted to confirm these study results.
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Affiliation(s)
- Lei Jiang
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, P.R. China
| | - Yan Huang
- Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, P.R. China
| | - Qiying Tang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200233, P.R. China
| | - Qingping Zhao
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, P.R. China
| | - Yuan Li
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, P.R. China
| | - Xiaodong Wu
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, P.R. China
| | - Huoqiang Wang
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, P.R. China
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15
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Cherian SV, Estrada-Y-Martin RM, Irani AD, Zhou J, Weissferdt A. A 33-Year-Old Woman With a Fluorodeoxyglucose-Avid Left Lower Lobe Mass. Chest 2017; 151:e119-e122. [PMID: 28483135 DOI: 10.1016/j.chest.2016.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 10/03/2016] [Accepted: 10/20/2016] [Indexed: 12/01/2022] Open
Abstract
A 33-year-old woman of Latin American origin was referred to our department by her primary care physician for a left lower lobe mass, which was incidentally found on a CT scan of her abdomen. The patient had complaints of abdominal pain for which she underwent imaging of her abdomen. Review of systems was negative for any respiratory complaints, and she denied any history of cigarette smoking or recreational drug use.
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Affiliation(s)
- Sujith V Cherian
- Divisions of Pulmonary, Critical Care and Sleep Medicine, University of Texas Health- McGovern Medical School, Houston, TX.
| | - Rosa M Estrada-Y-Martin
- Divisions of Pulmonary, Critical Care and Sleep Medicine, University of Texas Health- McGovern Medical School, Houston, TX
| | - Adel D Irani
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health- McGovern Medical School, Houston, TX
| | - Jain Zhou
- Department of Pathology and Laboratory Medicine, University of Texas Health- McGovern Medical School, Houston, TX
| | - Annikka Weissferdt
- Department of Pathology, The University of Texas- MD Anderson Cancer Center, Houston, TX
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16
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Fayers RW, Lim TS, Havlat MF. Pulmonary sclerosing pneumocytoma (sclerosing haemangioma): Radical radiation therapy. J Med Imaging Radiat Oncol 2016; 60:693-695. [PMID: 27302690 DOI: 10.1111/1754-9485.12477] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Abstract
We present a case of pulmonary sclerosing pneumocytoma (PSP) - (Formerly known as pulmonary sclerosing haemangioma) which was successfully treated with definitive radical external beam radiation therapy (EBRT). To our knowledge, such a treatment response has not been described in the literature.
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Affiliation(s)
- Russell Wb Fayers
- Department of Radiation Oncology (Genesis Cancer Care), Royal Perth Hospital, Perth, Western Australia, Australia.
| | - Tee S Lim
- Department of Radiation Oncology (Genesis Cancer Care), Royal Perth Hospital, Perth, Western Australia, Australia
| | - Marek F Havlat
- Western Diagnostic Pathology, Myaree, Western Australia, Australia
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17
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Maeda H, Kanzaki M, Isaka T, Onuki T. Video-assisted thoracoscopic enucleation after congenital cardiac surgery. J Surg Case Rep 2015; 2015:rjv123. [PMID: 26385193 PMCID: PMC4574196 DOI: 10.1093/jscr/rjv123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A 26-year-old man underwent arterial switch surgery for transposition of the great arteries in infancy. During a routine evaluation, a nodule was detected in the left lower lobe on chest computed tomography. The tumor had enlarged at follow-up and he underwent surgical resection. Because of past cardiac surgery, the pericardium was defective; therefore, the heart was exposed to the pleural cavity and severe adhesions surrounding the left lung. We had to encircle the left main pulmonary artery to perform enucleation safely. The tumor was diagnosed as a pulmonary sclerosing hemangioma using permanent pathology results.
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Affiliation(s)
- Hideyuki Maeda
- Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan
| | - Masato Kanzaki
- Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan
| | - Tamami Isaka
- Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan
| | - Takamasa Onuki
- Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan
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18
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CASO CLÍNICO: HEMANGIOMA ESCLEROSANTE (NEUMOCITOMA) PULMONAR. REVISTA MÉDICA CLÍNICA LAS CONDES 2015. [DOI: 10.1016/j.rmclc.2015.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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19
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De Luca G, Martucci N, Setola S, Rocco G. Sclerosing hemangioma of the lung mimicking pulmonary metastasis. Lung 2015; 193:447-8. [PMID: 25762452 DOI: 10.1007/s00408-015-9711-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
Abstract
Sclerosing hemangioma (SH) of the lung is a rare, benign neoplasm, initially thought to be of vascular origin, but immunohistochemical results suggest an origin from primitive respiratory epithelium. We report a case of SH initially misdiagnosed as malignant due to the strong FDG-PET uptake.
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Affiliation(s)
- G De Luca
- Division of Thoracic Surgery, Department of Thoracic Surgery and Oncology, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", Via M. Semmola, 80016, Naples, Italy,
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20
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Amini B, Huang SY, Tsai J, Benveniste MF, Robledo HH, Lee EY. Primary lung and large airway neoplasms in children: current imaging evaluation with multidetector computed tomography. Radiol Clin North Am 2013; 51:637-57. [PMID: 23830790 DOI: 10.1016/j.rcl.2013.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Multidetector computed tomography (MDCT) offers an important noninvasive imaging modality for confirmation and further characterization of primary lung and large airway neoplasms encountered in pediatric patients. Children represent a unique challenge in imaging, not only because of unique patient factors (eg, inability to follow instructions, motion, need for sedation) but because of the technical factors that must be optimized to reduce radiation dose. This article reviews an MDCT imaging algorithm, up-to-date imaging techniques, and clinical applications of MDCT for evaluating benign and malignant primary neoplasms of lung and large airway in infants and children.
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Affiliation(s)
- Behrang Amini
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
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21
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Chu M, Kumari H, Salmah N, Sachithanandan A. Synchronous sclerosing haemangiomas of the lung: an unusual presentation of a rare tumour. BMJ Case Rep 2013; 2013:bcr-2013-008829. [PMID: 23456164 DOI: 10.1136/bcr-2013-008829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Pulmonary sclerosing haemangioma is a rare lung tumour with a preponderance for Asian oriental women. Typically a well-circumscribed, solitary lesion with benign characteristics, there are concerns of malignant potential including regional lymph node metastases. Four histological subtypes exist. Diagnosis can be challenging as patients are usually asymptomatic and radiological findings are non-specific. Surgical resection alone is diagnostic and therapeutic. We present a case of this rare tumour with an uncommon presentation as two synchronous tumours initially misdiagnosed as a pulmonary adenocarcinoma.
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Affiliation(s)
- Michael Chu
- University of Manchester Medical School, Manchester, UK
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