Solitary pulmonary capillary hemangioma: An under-recognized pulmonary lesion mimicking early lung cancer on computed tomography images
Journal
Lung Cancer
Journal Volume
124
Pages
227-232
Date Issued
2018
Author(s)
Abstract
Objectives: Solitary pulmonary capillary hemangioma (SPCH) is a rare lung tumor typically presenting as pure or part-solid ground-glass nodules (GGNs) on computed tomography (CT), which clinically resembles early lung cancer. Materials and Methods: In addition to 10 recently diagnosed patients with SPCH, 71 benign lung nodules that were surgically resected between January 2013 and December 2017 were reviewed by thoracic pathologists to identify any previously unrecognized SPCH cases. Finally, 6 tumors (8.5%; 6/71) were determined to be SPCH. Elastic fiber stain (orcein stain) as well as immunohistochemistry for cytokeratin, CD31, and thyroid transcription factor 1 were performed for confirmation. Clinical and radiological data were analyzed. Results: All 16 SPCH lesions were unrecognized or misdiagnosed by general pathologists. The SPCH ranged in size from 3 to 15 mm, and a predominance among women (68.8%; 11/16) was noted. Pathologically, all SPCH lesions were nodular with a higher vascular density than the adjacent lung tissue. Decreased cytokeratin staining and disrupted elastic fibers were clearly observed in all SPCH lesions. Conclusions: SPCH lesions mimic early lung cancer on CT; they are largely unrecognized by general pathologists and are diagnosed as other nonspecific benign lesions. With careful histologic examination, SPCH can be successfully diagnosed using cytokeratin/CD31 immunohistochemistry and elastic fiber staining. ? 2018 Elsevier B.V.
SDGs
Other Subjects
cytokeratin; homeobox protein Nkx 2.1; platelet endothelial cell adhesion molecule 1; keratin; adult; Article; cancer diagnosis; cancer surgery; cavernous hemangioma; clinical article; clinical feature; controlled study; early cancer; elastic fiber; female; human; human tissue; immunohistochemistry; lung cancer; lung nodule; lung parenchyma; male; priority journal; pulmonary capillary hemangiomatosis; solitary pulmonary capillary hemangioma; x-ray computed tomography; aged; capillary hemangioma; diagnostic error; differential diagnosis; elastic tissue; lung; lung tumor; metabolism; middle aged; pathology; prevention and control; sex factor; tumor volume; Adult; Aged; Diagnosis, Differential; Diagnostic Errors; Elastic Tissue; Female; Hemangioma, Capillary; Humans; Keratins; Lung; Lung Neoplasms; Male; Middle Aged; Sex Factors; Solitary Pulmonary Nodule; Tomography, X-Ray Computed; Tumor Burden
Publisher
Elsevier Ireland Ltd
Type
journal article