Co-occurrence of bronchial papilloma and pulmonary sclerosing hemangioma in a male

[Analysis of Clinical Characteristics of 35 Cases of Pulmonary Sclerosing Pneumocytoma]

BACKGROUND

Pulmonary sclerosing pneumocytoma (PSP) is rare benign lung tumor which usually develops in middle-aged women without typical clinical and imaging findings. PSP consists of two basic cell types (surface cubic epithelial cells and round mesenchymal cells) and four histological types (hemorrhagic, sclerotic, solid and papillary). It grows slowly, but it can metastasize to distant organs. The pathology before surgery is easily misdiagnosed. This study aims to improve clinicians' understanding of PSP by discussing the clinical characteristics of the disease.

METHODS

This represents a retrospective study of thirty-five patients diagnosed with pulmonary sclerosing pneumocytoma by pathological examination from January 2011 to December 2019.

RESULTS

A total of 35 patients in this study, 12 cases were male and 23 cases were female, the average age is 51 years old. 7 cases were discovered accidentally by physical examination or routine chest computed tomography (CT), and 28 cases were found due to symptoms such as cough, sputum, hemoptysis and chest pain. The imaging changes is mainly featured with isolated or clear circular or round-like single nodule and lump in the lungs. In this group, 12 cases underwent percutaneous lung biopsy, only 7 cases were diagnosed with PSP. A total of 28 patients underwent surgery, 24 cases underwent rapid frozen pathological biopsy, only 5 cases diagnosed with PSP. Postoperative pathological examination results shows that 1 case was diagnosed with keratotic squamous cell carcinoma with partial PSP, and the rest were diagnosed with PSP. The surgical and non-surgical patients were followed up for 1 to 8 years after discharge, and the overall recovery was good. The patients were no recurrence and metastasis on chest CT review.

CONCLUSIONS

PSP is a clinically rare benign lung tumor, which is more common in middle-aged women. The clinical manifestations and imaging features are lack of significance. Percutaneous lung puncture pathological examination and intraoperative rapid frozen pathological sections often leads to misdiagnosis. Final diagnosis relies on postoperative pathological work-up for most cases.

Sclerosing pneumocytoma: Case report of a rare endobronchial presentation

RATIONALE

Sclerosing pneumocytoma is a rare benign lung neoplasm seen in middle aged adults with a female predominance. Originally thought to be vascular in origin, this rare entity is now understood to be epithelial in nature. On imaging, sclerosing pneumocytoma manifests as a well circumscribed nodule or mass, often juxtapleural in location. On histopathology, sclerosing pneumocytoma is composed of cuboidal "surface cells" and round "stromal cells," both of which show nuclear staining for thyroid transcription factor-1 (TTF-1). Here we review the existing literature on sclerosing pneumocytoma and present a case of sclerosing pneumocytoma in a highly unusual endobronchial location.

PATIENT CONCERNS

This case is a 43 year old woman who presented with chronic cough.

DIAGNOSIS

Imaging revealed a right upper lobe nodule with an endobronchial component.

INTERVENTIONS AND OUTCOMES

Endoscopic biopsy was performed, and pathologic diagnosis was confirmed.

LESSONS

Although extremely rare, endobronchial presentation of sclerosing pneumocytoma is possible, and should remain on the differential for patients with endobronchial pulmonary lesions. Pathologic tissue analysis is necessary to confirm this uncommon diagnosis.