Pulmonary sclerosing hemangioma with a rare symptom: A case report and review of the literature

Abstract

Pulmonary sclerosing hemangioma (PSH) is a relatively rare benign tumor. However, as it occurs only rarely, the natural course of the tumor is not well understood. In the present study, a case is presented of a 35-year-old woman who underwent intermittent fevers for more than one year. This case highlighted fever as a rare symptom of PSH. Fever is possibly one of the symptoms of PSH, although it is less likely to occur. Another symptom of the patient was that the tumor grew quickly in two months. The lesion was diagnosed as multiple sclerosing hemangioma of the lung (i.e., PSH), in which papillary, solid and sclerotic patterns appeared. Immunohistochemical evaluation of the lesion revealed positive staining for thyroid transcription factor 1 (TTF1), epithelial membrane antigen (EMA), pancytokeratin (PCK) and cytoskeleton 7 (CK7). In the present case study, the biological activity of PSH was identified to be aggressive. A review of the literature was performed in order to comment further on the clinical and pathological features of this rare disease.

Keywords: computed tomography; pathology; pulmonary sclerosing hemangioma.

Figure 1.

Comparison of the CT examinations. (A) Contrast-enhanced CT examination of the chest on admission. (B) CT examination of the patient two months later. CT, computed tomography.

Figure 2.

Pathological diagnosis of the patient. (A) The papillary pattern is illustrated (magnification, ×200). Cuboidal cells are located on the papillary surface, and polygonal cells are in the stroma. (B) The sclerotic pattern is shown (magnification, ×40). Hyaline collagen tissue is shown around the hemorrhagic areas. (C) Both the cuboidal and the polygonal cells stained positively for thyroid transcription factor 1 (magnification, ×100). (D) Epithelial membrane antigen highlighted both the cuboidal cells and polygonal cells (magnification, ×100).