Pulmonary pneumocytoma

Last revised by Daniel J Bell on 22 Sep 2022

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 recognized female predilection. 

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

Pulmonary pneumocytoma 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.

Pulmonary pneumocytomas demonstrate significant size variability with lesions ranging from 1-8 cm in diameter, but majority 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 juxtapleural)
  • areas of calcification may be present
  • may show a radiolucent zone around the lesion 5
  • shows significant but inhomogeneous enhancement 2,8

Pulmonary pneumocytomas were first described by A A Leibow and D S Hubell et al. in 1956 3.

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