J Korean Soc Radiol.  2014 May;70(5):347-350. 10.3348/jksr.2014.70.5.347.

Computed Tomography Findings of Alveolar Adenoma of the Lung with Histopathologic Comparison: A Case Report

• Kim DY
• Ryu DS
• Gang GH
• Park MS
• Choi SJ
• Ahn JH
• Shin DR
• Yoo DG

• KMID: 1941779
• DOI: http://doi.org/10.3348/jksr.2014.70.5.347

Abstract

Alveolar adenoma is a rare pulmonary neoplasm with a female predominance, and it was considered to be a histologic variant of sclerosing hemangioma in the past. A chest X-ray usually shows a well-defined, peripheral, solitary nodule similar to that of sclerosing hemangioma. Chest CT shows a solitary, well-defined, peripheral nodule with homogeneous density and no contrast enhancement, which is contrary to marked contrast enhancement of sclerosing hemangioma. We report the first case of alveolar adenoma with spotty enhancement of the nodule similar to that of sclerosing hemangioma on contrast enhanced CT, based on the presence of stromal vessels in the interstitium of the compact alveolar area on histopathologic comparison.

MeSH Terms

Adenoma*
Female
Histiocytoma, Benign Fibrous
Humans
Lung Neoplasms
Lung*
Thorax
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A 57-year-old woman with alveolar adenoma. A. HRCT with mediastinal setting shows lung nodule with homogenous and low-attenuation (15 Hounsfield unit, HU) compared with that of chest wall muscle (25 HU). The lung nodule with smooth margin is located in the subpleural portion of the lingular segment of the left upper lobe, measuring 1.5 cm in size. B. Contrast enhanced CT shows heterogenous attenuation with mainly low attenuation (25 HU) in the center portion (arrow) and focal enhancement (67 HU) in the left lower lateral portion (arrowhead) of the nodule. C. Contrast enhanced CT shows spotty enhancement (70 HU) in the lower portion of the nodule (arrows). D. Photomicrograph (H&E stain; magnification: × 1) shows a round nodule consisting of stromal vessels of the solid area (arrows) in left half of nodule and cystic component (arrowheads) in right half of nodule. E. Dilated cystic alveolar area alternating with compacted small alveolar area (arrows). The compact small alveolar area has higher density of stromal vessels than that of cystic area (H&E, × 100). The final pathologic report was alveolar adenoma. F. CD34 immunohistochemical stain (× 100) highlighting the difference of stromal vessel density between dilated cystic alveolar area and compact small alveolar area. Stromal vessel is stained as dark brown channel or line (arrows).

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