Placental transmogrification of the lung

Abstract

Placental transmogrification is a very rare lung disease, where the alveoli resemble the chorionic villi of placenta, and this change is a characteristic finding. A 31-year-old female patient presented with cough and dyspnea that had begun 2 weeks prior to admission. Along with giant bulla found in the left upper lung field, subsegmental consolidation was also identified in the lingular segment on plain chest radiograph and CT scan. Wedge resection was performed to remove the bulla. Pathologic examination of the resected bulla revealed destruction of the normal structures and characteristic villous and papillary changes. These changes led to a diagnosis of placental transmogrification. We made an encounter of an unusual placental transmogrification which had different image findings from other reported transmogrification cases. Thus, we report an atypical placental transmogrification case where both consolidation and giant bulla coexist.

Keywords: Chorionic villi; Emphysema; Lung; Placenta.

Fig. 1

Thirty-one-year-old female patient with large bullae and subsegmental consolidation in left upper lobe. A. Preoperative chest computed tomography shows multiple giant bullae in left upper lobe with resultant mediastinal shifting. B. Subsegmental consolidation in left lingular segment has broad contact with bullae. C. Pleural surface shows several massively dilated bullae, largest one measuring 11 × 5 × 3 cm in size. D. On high power, villous structures are composed of simple cuboidal cell linings and edematous cores. Immunohistochemical stain for CD-10 is positive only in interstitial cells (IHC, × 400).