Morikawa Kazuhiko, Misumi Shigeki, Fukuda Taiki, Ojiri Hiroya, Matsudaira Hideki, Sato Shun
Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan.
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Radiol Case Rep. 2019 Mar 7;14(5):602-607. doi: 10.1016/j.radcr.2019.02.024. eCollection 2019 May.
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.
肺硬化性肺细胞瘤是一种罕见的生长缓慢的良性肿瘤,通常发生于中年女性,一般表现为单个边界清晰的结节。一名18岁女性在胸部X线检查时偶然发现有多个肺结节,这些结节在7年时间里缓慢增大。计算机断层扫描图像显示左肺有多个边界清晰的结节,周围有许多较小的结节,最大直径为3厘米。进行了经皮芯针活检,但由于乳头状结构比例较高,无法排除恶性肿瘤。遂进行了电视辅助部分楔形切除术,病理诊断为肺硬化性肺细胞瘤。表现为多个肺结节的肺硬化性肺细胞瘤较为罕见,但在多个肺结节的鉴别诊断中是一个非常重要的需要考虑的情况。术前活检存在误诊为其他类型肿瘤或恶性肿瘤的可能性。我们不仅要了解肺硬化性肺细胞瘤的临床、放射学和病理学特征,还要了解其诊断和治疗中潜在的陷阱。