[논문]Huge Pulmonary Sclerosing Pneumocytoma with Endobronchial Invasion: A Case Report with a Literature Review

Lee, Hyun Soo; Kim, Jina; Moon, Duk Hwan; Park, Chul Hwan; Jeon, Tae Joo; Lee, Sungsoo; Cha, Yoon Jin

doi:10.5090/jcs.21.016

Huge Pulmonary Sclerosing Pneumocytoma with Endobronchial Invasion: A Case Report with a Literature Review 원문보기

Journal of chest surgery, v.54 no.6, 2021년, pp.528 - 531

Lee, Hyun Soo (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) , Kim, Jina (Department of Radiology and the Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine) , Moon, Duk Hwan (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) , Park, Chul Hwan (Department of Radiology and the Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine) , Jeon, Tae Joo (Department of Nuclear medicine, Gangnam Severance Hospital, Yonsei University College of Medicine) , Lee, Sungsoo (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) , Cha, Yoon Jin (Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine)

Abstract ▼ AI-Helper

Pulmonary sclerosing pneumocytoma (PSP) is a tumor of pneumocytic origin that is classified as a benign neoplasm. To date, aggressive behavior of this tumor has rarely been reported. Here, we describe a case of a 56-year-old woman with a huge, 19-cm PSP that resulted in mediastinal shift and showed microscopic endobronchial invasion and necrosis. The differential diagnosis included malignant mesenchymal tumors, such as solitary fibrous tumor; however, PSP was confirmed based on the characteristic thyroid transcription factor 1 positivity and membranous expression of Ki-67 on immunohistochemical staining of tumor cells.

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그림 Fig. 1. (A) Posteroanterior-view chest radiograph shows a huge mass in the left hemithorax with complete atelectasis of the left lung and rightward deviation of the mediastinum. (B) Chest computed tomography image with coronal reformation reveals a low-density area in the center of the tumor, suggesting hemorrhage and necrosis. Endobronchial extension of the tumor is also noticed. (C) Endobronchial lesion in the left main bronchus confirmed by bronchoscopy. (D) Positron emission tomography image shows a well-defined, huge mass with diffusely increased glucose metabolism, central defects, and strong fluorodeoxyglucose uptake.
그림 Fig. 2. (A) Cut surface of the mass shows a well-circumscribed, hemorrhagic, tan mass with central degenerative changes. (B) Scan power view shows extensive hemorrhagic lakes with cellular and acellular areas. Necrosis is seen in the left lower part.
그림 Fig. 3. (A) Solid pattern and sclerosis associated with a blood lake (left). (B) Immunohistochemical staining of tumor cells for thyroid transcription factor 1 is diffusely and strongly positive. (C) Membranous expression of Ki-67 on manual staining, which is a characteristic feature of sclerosing pneumocytoma. (D) Tumor cells invading the bronchial subepithelium.
그림 Fig. 4. (A) Epithelial component of an acinar pattern with an intervening stromal cell component. (B) Epithelial component shows strong positivity for cytokeratin immunohistochemistry. (C) Both epithelial and stromal components are positive for epithelial membrane antigen immunohistochemistry.

참고문헌 (8)

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Huge Pulmonary Sclerosing Pneumocytoma with Endobronchial Invasion: A Case Report with a Literature Review 원문보기

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