Pulmonary pneumocytoma

Pulmonary pneumocytomas, previously known as pulmonary sclerosing hemangiomas (PSH), are rare benign neoplasms of the lung.

Epidemiology

Typically presents in middle age (30-50 years of age). There is a recognized female predilection.

Clinical presentation 

Most patients are asymptomatic. Symptoms if present will include hemoptysis, cough, chest pain (maybe pleuritic) and breathlessness.

Pathology

It is a rare benign tumor which is microscopically characterized by four main histological components (solid, papillary, sclerotic, and hemangiomatous) in varying proportions. A thin fibrous pseudocapsule separates it from the adjacent compressed lung parenchyma.

Radiographic features

There can be significant size variability where the lesions range from 1~8 cm in diameter, although most are <3.5 cm.

Plain radiograph
  • they usually tend to present as a solitary, well-defined nodular lesion (oval to rounded shadow)
  • they occasionally contain areas of calcification
  • may show an air-meniscus sign: crescentic radiolucency at the periphery of a lung nodule
CT
  • often seen as a well defined intraparechymal nodular mass (often juxta-pleural)
  • areas of calcification may be present
  • may show a radiolucent zone around the lesion
  • shows significant but inhomogeneous enhancement

History and etymology

It was first described by A A Leibow and D S Hubell et al. in 1956 .

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