A Challenge： Pulmonary Sclerosing Haemangioma  

作　　者：Tong-Tong Li Xu Yan Tong Zhou Zhen-Xiang Yu 

机构地区：[1]Department of Respiration, The First Hospital of Jilin University, Changchun, Jilin 130021, China [2]Department of Pathology, The First Hospital of Jilin University, Changchun, Jilin 130021, China [3]Department of Endocrinology, The First Hospital of Jilin University, Changchun, Jilin 130021, China

出　　处：《Chinese Medical Journal》2018年第19期2390-2391,共2页中华医学杂志（英文版）

基　　金：This study was supported by a grant from the Natural Science Foundation of Jilin Province （No. 20180101099JC）.

摘　　要：A 48-year-old woman had a symptom of chest pain a month ago, without obvious inducement, coughing, sputum, hemoptysis, or chest tightness. The pain in the chest was irregular. The patient was admitted to the First Hospital of lilin University for further treatment. The patient denied the history of hypertension, coronary heart disease, diabetes mellitus, and other diseases. She also denied family history of hereditary disease. However, she has had a smoking history for 20 years, about 10 cigarettes per day, no quit. Physical examination and blood tests did not show apparent abnormality. All tumor markers were negative. The computed tomography （CT） showed a high-density mass of right upper lobe of the lung, which was about 17 mm × 15 mm [Figure 1 a]. The boundary was smooth, and the density was uniform. The image of a narrow arc of fluid was seen in the right thoracic cavity and there was no significant lymph node （LN） metastasis in the mediastinum [Figure lb]. The patient underwent exploration under thoracoscope, and the intraoperative rapid pathology showed suspicious adenocarcinoma, the patient received the resection of the upper lobe of the right lung. However, the final pathology revealed the pulmonary sclerosing hemangioma （PSH）. Microscopic findings of the postoperative specimen showed a mixture of papillary and sclerotic patterns with two cell types as follows： cuboidal surface and stromal round cells. The cuboidal surface cells resembling pneumocytes and round stromal cells with well-defined borders were centrally located round to oval vesicular nuclei and rare nucleoli. The round stromal cells mostly had slightly eosinophilic cytoplasm with some showing a more vacuolated or foamy appearance. In other areas, there were large blood-filled spaces lined by flattened cells. Solid sheets of round cells with scattered cuboidal surface cells forming small tubules were also noted [Figure 1c].A 48-year-old woman had a symptom of chest pain a month ago, without obvious inducement, coughing, sputum, hemoptysis, or chest tightness. The pain in the chest was irregular. The patient was admitted to the First Hospital of lilin University for further treatment. The patient denied the history of hypertension, coronary heart disease, diabetes mellitus, and other diseases. She also denied family history of hereditary disease. However, she has had a smoking history for 20 years, about 10 cigarettes per day, no quit. Physical examination and blood tests did not show apparent abnormality. All tumor markers were negative. The computed tomography （CT） showed a high-density mass of right upper lobe of the lung, which was about 17 mm × 15 mm [Figure 1 a]. The boundary was smooth, and the density was uniform. The image of a narrow arc of fluid was seen in the right thoracic cavity and there was no significant lymph node （LN） metastasis in the mediastinum [Figure lb]. The patient underwent exploration under thoracoscope, and the intraoperative rapid pathology showed suspicious adenocarcinoma, the patient received the resection of the upper lobe of the right lung. However, the final pathology revealed the pulmonary sclerosing hemangioma （PSH）. Microscopic findings of the postoperative specimen showed a mixture of papillary and sclerotic patterns with two cell types as follows： cuboidal surface and stromal round cells. The cuboidal surface cells resembling pneumocytes and round stromal cells with well-defined borders were centrally located round to oval vesicular nuclei and rare nucleoli. The round stromal cells mostly had slightly eosinophilic cytoplasm with some showing a more vacuolated or foamy appearance. In other areas, there were large blood-filled spaces lined by flattened cells. Solid sheets of round cells with scattered cuboidal surface cells forming small tubules were also noted [Figure 1c].

分 类 号：R563[医药卫生—呼吸系统]