Lee Ko, Sasaki Mamoru, Kakimoto Tomoo, Morinaga Shojiroh, Yamamoto Tatsuya, Iwamaru Arifumi, Ogata Kentaro, Minematsu Naoto
Department of Internal Medicine, Hino Municipal Hospital, Hino-shi, Tokyo, Japan.
Department of Diagnostic Pathology, Hino Municipal Hospital, Hino-shi, Tokyo, Japan.
Respir Med Case Rep. 2019 May 29;28:100870. doi: 10.1016/j.rmcr.2019.100870. eCollection 2019.
Pulmonary sclerosing pneumocytoma (PSP) is a rare benign neoplasm of the lung that shows a slow growing pattern. Corresponding contrast-enhancements on chest computed tomography (CT) vary widely in both patterns and degrees. However, gross intratumoral radiolucencies, attributable to cyst formation, necrosis, or intratumoral hematoma, were rarely reported in PSP cases. We herein report on a case involving a 61-year-old Japanese women with PSP demonstrating CT-defined intratumoral radiolucency. A chest CT scan revealed a solitary and well-circumscribed nodule that showed a substantial growth over a 7-year period. The tumor was composed of a solid portion visualized with contrast-enhancement and a central radiolucency on a chest CT scan. A positron emission tomography scan revealed high uptake of fluorodeoxyglucose on the solid portion of the tumor, but the radiolucent portion showed negative uptake. The examination of a tumor specimen obtained by a percutaneous core needle biopsy aided in determining a pathological diagnosis of PSP, and the patient subsequently received a right lower lobectomy of the lung. The portion of central radiolucency on the CT scan corresponding to the surgical specimen was pathologically proven to be gross hematoma.
肺硬化性肺细胞瘤(PSP)是一种罕见的肺部良性肿瘤,生长缓慢。胸部计算机断层扫描(CT)上相应的对比增强在模式和程度上差异很大。然而,PSP病例中很少报告因囊肿形成、坏死或瘤内血肿导致的瘤内透亮区。我们在此报告一例61岁日本女性PSP病例,其CT显示瘤内透亮区。胸部CT扫描显示一个孤立且边界清晰的结节,在7年时间里有显著生长。肿瘤由胸部CT扫描上增强显影的实性部分和中央透亮区组成。正电子发射断层扫描显示肿瘤实性部分对氟脱氧葡萄糖摄取高,但透亮部分摄取为阴性。经皮芯针活检获得的肿瘤标本检查有助于确定PSP的病理诊断,患者随后接受了右下肺叶切除术。CT扫描上与手术标本对应的中央透亮区经病理证实为大体血肿。