Division of Cardiothoracic Imaging, Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, United States of America.
Division of Cardiothoracic Imaging, Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, United States of America.
Clin Imaging. 2021 Sep;77:175-179. doi: 10.1016/j.clinimag.2021.02.028. Epub 2021 Feb 27.
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 (Ga)-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 (F-FDG) positron emission tomography (PET) demonstrated low-level FDG uptake, but a Ga-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 Ga-DOTATATE-avid solitary lung nodule concerning for carcinoid tumor, in all genders and in ethnicities other than East Asian.
肺硬化性血管皮细胞瘤(PSP)是一种起源于原始呼吸上皮的良性肿瘤,通常表现为肺外周的无症状单发病变。它主要发生在女性,女性与男性的比例为 5:1,并且常见于东亚人群。我们描述了一个罕见的病例,一名北非裔中年男性患有镓-68(Ga)-DOTATATE 亲和性 PSP。增强 CT 显示左肺上叶外周有一个 2cm 大小的椭圆形强化实性病变,与左侧心室侧壁的上部相邻。氟-18-氟代脱氧葡萄糖(F-FDG)正电子发射断层扫描(PET)显示低水平的 FDG 摄取,但 Ga-DOTATATE PET/CT 显示摄取剂摄取活跃,提示类癌肿瘤。病变通过手术切除,组织病理学分析显示出 PSP 的典型形态学和组织化学标志物。我们的结论是,尽管罕见,但在评估 Ga-DOTATATE 亲和性孤立性肺结节是否为类癌肿瘤时,PSP 可以作为一种鉴别诊断,不仅在女性中,而且在东亚以外的所有种族中都可以考虑。