Pulmonary pneumocytomas, previously known as pulmonary sclerosing hemangiomas (PSH), are rare benign neoplasms of the lung.
Typically presents in middle age (30-50 years of age). There is a recognised female predilection.
Most patients are asymptomatic. Symptoms if present will include hemoptysis, cough, chest pain (maybe pleuritic) and breathlessness.
It is a rare benign tumor which is microscopically characterized by four main histological components (solid, papillary, sclerotic, and haemangiomatous) in varying proportions. A thin fibrous pseudocapsule separates it from the adjacent compressed lung parenchyma.
There can be significant size variability where the lesions range from 1~8 cm in diameter, although most are <3.5 cm.
- 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 4
- 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 5
- shows significant but inhomogeneous enhancement 2,8
History and etymology
It was first described by A A Leibow and D S Hubell et al. in 1956 3.
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- 2. Yi CA, Lee KS, Kim EA et-al. Solitary pulmonary nodules: dynamic enhanced multi-detector row CT study and comparison with vascular endothelial growth factor and microvessel density. Radiology. 2004;233 (1): 191-9. doi:10.1148/radiol.2331031535 - Pubmed citation
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- 4. Bahk, Yong Whee; Shinn, Kyung Sub; Choi, Byung Suk. The Air Meniscus Sign in Sclerosing Hemangioma of the Lung Radiology. 128 (1): 27. doi:10.1148/128.1.27
- 5. Nam JE, Ryu YH, Cho SH et-al. Air-trapping zone surrounding sclerosing hemangioma of the lung. J Comput Assist Tomogr. 26 (3): 358-61. J Comput Assist Tomogr (link) - Pubmed citation
- 6. Kitagawa H, Goto A, Minami M et-al. Sclerosing hemangioma of the lung with cystic appearance. Jpn. J. Clin. Oncol. 2003;33 (7): 360-3. doi:10.1093/jjco/hyg067 - Pubmed citation
- 7. Sugio K, Yokoyama H, Kaneko S et-al. Sclerosing hemangioma of the lung: radiographic and pathological study. Ann. Thorac. Surg. 1992;53 (2): 295-300. - Pubmed citation
- 8. Cheung YC, Ng SH, Chang JW et-al. Histopathological and CT features of pulmonary sclerosing haemangiomas. Clin Radiol. 2003;58 (8): 630-5. Clin Radiol (link) - Pubmed citation
- 9. Wang QB, Chen YQ, Shen JJ et-al. Sixteen cases of pulmonary sclerosing haemangioma: CT findings are not definitive for preoperative diagnosis. Clin Radiol. 2011;66 (8): 708-14. doi:10.1016/j.crad.2011.03.002 - Pubmed citation
- 10. Baysak A, Oz AT, Moğulkoç N et-al. A rare tumor of the lung: pulmonary sclerosing hemangioma (pneumocytoma). Respir Med. 2013;107 (3): 448-50. doi:10.1016/j.rmed.2012.12.005 - Pubmed citation
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