A Rare Pulmonary Tumor Mimicking Lung Cancer: Sclerosing Pneumocytoma

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Austin J Pathol Lab Med. 2019; 6(1): 1024.

A Rare Pulmonary Tumor Mimicking Lung Cancer: Sclerosing Pneumocytoma

Elktaibi A¹*, Pirel M¹, Marty-Ané C², Serre I¹ and Costes Martineau V¹

1Department of Pathology, Gui de Chauliac Teaching Hospital, France

2Department of Cardiac, Thoracic Vascular Surgery, Arnaud De Villeneuve Hospital, France

*Corresponding author: Elktaibi A Department of Pathological Anatomy Gui de Chauliac Teaching Hospital, France

Received: August 07, 2019; Accepted: August 26, 2019; Published: September 02, 2019


Pulmonary sclerosing pneumocytoma is an uncommon benign tumor of the lung with a predilection for middle-aged females. Diagnosis is often made incidentally following chest computed tomography scan performed for systematic check-up. We report a case of Pulmonary sclerosing pneumocytoma in a 53 year-old female who got admitted for medical control of her malignancy. Radiology a single, well-circumscribed mass infiltrating the right lung. Histological examination showed a tumor which was composed of mixture patterns with solid, cystic, and papillary structures. A panel of immunohistochemical markers was performed and the tumor was finally diagnosed to be sclerosing pneumocytoma.

Keywords: Sclerosing pneumocytoma; Histopathology; Surgery


Pulmonary Sclerosing Pneumocytoma (PSP) is a rare benign lung tumor, which was previously reported and named sclerosing hemangioma in 1956 by Liebow [1]. It was categorized as a ‘miscellaneous tumor’ according to the 1999 and 2004 World Health Organization classification of lung tumors [2]. In 2015, the most recent WHO classification changed the name of this tumor. It is now called sclerosing pneumocytoma and is classifed in the category of adenomas. Due to its rarity, the clinical symptoms and preoperative imaging performance lacks specificity [3]. In the present study, we report a case of PSP in patient with history of malignancy due to its rare occurrence and to investigate the clinicopathological characteristics with a brief review of the literature

Case Presentation

A 53-year-old woman with remarkable medical history: - Osteosarcoma of the left femur diagnosed and treated in 2006 - Papillary carcinoma of the thyroid treated in 2012 and followed by mammary carcinoma in 2017 with good therapeutic response. She was presented for a medical checkup. The computed tomography scan of the thorax demonstrated a 26 mm nodular isolated lesion in the lower lobe of the right lung (Figure 1). Clinically, a metastatic lesion was suggested because of the patient’s history. To confirm the diagnosis, wedge resection of the right lower lobe was performed and sent to pathological department for extemporaneous analysis. Gross examination demonstrated a well-circumscribed lesion, solid and cystic mass with hemorrhagic areas (Figure 2). The frozen section diagnosis was mesenchymal proliferation of undetermined malignant potential. After formalin fixation, microscopic observation schowed three morphologogical patterns. A papillary pattern was predominant, composed of cuboidal surface cells with benign features. The solid pattern of growth comprising sheets of round stromal cells with occasional epithelial/surface cells. A cystic component with hemorrhage was also noticed (Figure 3). Immunohistochemically, surface cuboidal cells are positive for Cytokeratin 7 (CK7), where as stromal round cells are focally positive for CK7. Both populations express Thyroid Transcription Factor-1 (TTF-1) and Epithelial Membrane Antigen (EMA). Progesterone showed nuclear immunoreactivity in the round stromal cells (Figure 4). This case was assigned to the molecular biology platform but no mutation was found in NGS (Next Generation Sequencing Panel INCa V2) technique. At the fourth month post-surgery follow-up appointment, the patient was alive with no evidence of recurrence or metastasis.