J Korean Soc Radiol.  2013 Oct;69(4):283-286. 10.3348/jksr.2013.69.4.283.

Radiological-Pathological Findings of Central Sclerosing Hemangioma Initially Misdiagnosed as Papillary Adenoma by Bronchoscopic Biopsy: A Case Report

• Kim SH
• Seon HJ
• Song JH
• Park SY
• Kim YH
• Choi YD
• Song SY

• KMID: 2041948
• DOI: http://doi.org/10.3348/jksr.2013.69.4.283

Abstract

Sclerosing hemangioma is relatively rare, the second most common benign pulmonary neoplasm, which usually presents the peripheral location. Central location of this neoplasm is extremely rare with only a few reports. Herein, we would like to report an extremely rare case of central sclerosing hemangioma with descriptions of radiological characteristics. It was initially misdiagnosed as a papillary adenoma by bronchoscopic biopsy and mimicked central lung malignancies such as carcinoid tumors on non-invasive image evaluations. However the patient was finally confirmed with surgery.

MeSH Terms

Adenoma
Biopsy
Carcinoid Tumor
Histiocytoma, Benign Fibrous
Humans
Lung
Lung Neoplasms

Figure

• 

  Fig. 1 Centrally located sclerosing hemangioma with endobronchial extension in a 58-year-old female. A. Initial chest PA radiograph shows about 3 cm sized nodular opacity (arrow) in right hilar area. B. The initial chest CT image shows about 3 cm sized well-defined central mass (arrow) with heterogeneous enhancement in right upper lobe (RUL). C. Bronchoscopy shows a protruding endobronchial lesion in posterior segmental bronchus of RUL (*). D. Only papillary pattern of tumor was obtained on initial biopsy (H&E, × 100). E. Follow-up CT image after 7 years from initial examination shows gradual increase of a central mass in RUL with endobronchial extension to posterior segmental bronchus (arrow). F. Follow-up positron emission tomography-CT image shows high fluorodeoxyglucose uptake of the central mass (arrow) and distal obstructive pneumonia and atelectasis (*) of RUL. G. A mixture of papillary, hemorrhagic, and sclerotic patterns is shown on final surgical specimen (H&E, × 10).

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