pulmonary sclerosing hemangioma

Pulmonary sclerosing hemangioma (PSH) can present with a range of symptoms, although most patients are asymptomatic.

Common symptoms if present may include:

• Hemoptysis (coughing up blood)
• Cough
• Chest pain (which may be pleuritic)
• Breathlessness

These symptoms are not always present and may vary in severity. In some cases, the tumor may grow quickly over a short period of time.

Radiographic findings:

On chest radiographs, PSH appears as a well-defined round or oval mass. CT scans have also been used to diagnose this condition, with findings including a solitary, well-defined, round or oval, homogeneous nodule or mass.

Clinical manifestations:

Some patients may experience clinical manifestations such as cough, hemoptysis, chest pain, and stuffiness. However, these symptoms are not always present and may vary in severity.

References:

• [4] Most patients are asymptomatic. Symptoms if present may include hemoptysis, cough, chest pain (maybe pleuritic) and breathlessness.
• [5] Most of the PSH patients are asymptomatic, and only some show clinical manifestations, including cough, hemoptysis, chest pain, and stuffiness.
• [7] A cough, chest pain and hemoptysis may also occur.

Diagnostic Tests for Pulmonary Sclerosing Hemangioma

Pulmonary sclerosing hemangioma (PSH) is a rare benign lung tumor that can be challenging to diagnose. While imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI) can provide characteristic findings, biopsy remains the definitive diagnostic test.

• Imaging Studies: CT scans are often used to evaluate PSH, and they may show well-circumscribed, yellow-tan masses in the peripheral lung [3]. Dynamic CT studies have shown marked homogeneous enhancement of the tumor [6].
• Biopsy: Fine-needle aspiration cytology (FNAC) can be used to diagnose PSH, but it is not always accurate. Intraoperative frozen section histology may prevent unnecessary resection of the tumor [5].
• Histopathological Examination: The diagnosis of PSH is based on histo-pathohistologic examination of the biopsy material. The tumor has four basic histologic patterns: hemorrhagic, papillary, solid, and sclerotic [10].

Key Points

• Imaging studies can provide characteristic findings, but biopsy remains the definitive diagnostic test.
• Fine-needle aspiration cytology (FNAC) may not always be accurate in diagnosing PSH.
• Histopathological examination of the biopsy material is essential for a definitive diagnosis.

References

[3] CPTJB Keylock · 2009 · Cited by 94 — On gross examination, sclerosing hemangiomas are well-circumscribed, yellow-tan masses located in the peripheral lung (Figure 2, A and B). [5] by MJ Chung · 2006 · Cited by 131 — Dynamic CT and MRI studies have shown that sclerosing hemangioma has marked homogeneous enhancement [4, 5]. [10] Sclerosing hemangioma is a rare pulmonary epithelial tumor with a dual cell population and four basic histologic patterns. The FNA diagnosis of sclerosing hemangioma is challenging, especially when one is unfamiliar with many various combinations of different histological patterns and thus should enter the differential diagnosis in solitary ...

Differential Diagnosis of Pulmonary Sclerosing Hemangioma

Pulmonary sclerosing hemangioma (PSH) is a rare benign lung tumor that can be challenging to diagnose due to its similarity in appearance with other lung lesions. The differential diagnosis for PSH includes:

• Tumefactive Organizing Pneumonia: This condition is characterized by the presence of inflammatory cells and fibrosis, which can mimic the appearance of PSH on imaging studies [1].
• True Pulmonary Hamartoma: A benign tumor composed of a mixture of cartilage, fat, and other tissues that can be difficult to distinguish from PSH [2].
• Papillary Adenocarcinoma: A type of lung cancer that can present as a solitary pulmonary nodule, similar to PSH [3].
• Carcinoid Tumor: A rare type of lung cancer that can mimic the appearance of PSH on imaging studies [4].
• Bronchoalveolar Adenocarcinoma: A type of lung cancer that can present as a solitary pulmonary nodule, similar to PSH [5].

Key Features for Differential Diagnosis

To differentiate PSH from these conditions, it is essential to consider the following key features:

• Imaging Characteristics: PSH typically presents as a well-circumscribed, solitary pulmonary nodule with a characteristic "popcorn" appearance on CT scans [6].
• Histopathological Features: PSH is characterized by the presence of cuboidal surface cells and polygonal stromal cells, which can be distinguished from other lung lesions through immunohistochemical studies [7].

Clinical Implications

Accurate diagnosis of PSH is crucial to avoid unnecessary surgical interventions or aggressive treatment. A thorough understanding of the differential diagnosis and key features of PSH can help clinicians make informed decisions about patient management.

References:

[1] Context 3 [2] Context 4 [3] Context 6 [4] Context 7 [5] Context 8 [6] Context 10 [7] Context 12