Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Fukuoka, Japan.
Division of Pathology, Saiseikai Fukuoka General Hospital, Fukuoka, Fukuoka, Japan.
Ann Thorac Cardiovasc Surg. 2022 Dec 20;28(6):438-443. doi: 10.5761/atcs.cr.21-00005. Epub 2021 May 12.
We report a 33-year-old man who presented with recurrent right pneumothorax. Computed tomography (CT) showed the presence of a large bulla with a maximum diameter of 8 cm in the right middle lobe; he subsequently underwent bullectomy. Histopathology revealed that pulmonary parenchyma adjacent to the bulla represented nodular proliferation of clear cells characterized by a papillary structure resembling placental chorionic villi. Immunohistochemically, clear cells were positive for CD10, suggesting placental transmogrification of the lung (PTL). We reviewed 36 surgical cases of PTL, and only 2 cases (5.6%), including our case, were operated for spontaneous pneumothorax. Bullous lesions secondary to PTL tend to appear as unilateral large cystic masses in non-upper lobes, which is atypical for primary spontaneous pneumothorax (PSP). Although PTL is considered a very rare cause of secondary pneumothorax, we must carefully differentiate this condition.
我们报告了 1 例 33 岁男性患者，他反复出现右侧气胸。计算机断层扫描（CT）显示右中叶有一个最大直径为 8 厘米的大疱；随后他接受了疱切除术。组织病理学显示，与大疱相邻的肺实质表现为透明细胞的结节性增生，具有类似于胎盘绒毛膜绒毛的乳头状结构。免疫组化显示透明细胞 CD10 阳性，提示肺胎盘转位（PTL）。我们回顾了 36 例 PTL 的手术病例，只有 2 例（5.6%），包括我们的病例，因自发性气胸而行手术治疗。PTL 引起的大疱性病变往往表现为非上叶的单侧大囊性肿块，这与原发性自发性气胸（PSP）不同。虽然 PTL 被认为是继发性气胸的一种非常罕见的原因，但我们必须仔细区分这种情况。
