Pulmonary sclerosing pneumocytoma is a rare, benign lung tumor commonly seen in women in the fifth decade of life. It usually manifests as a solitary, well-circumscribed juxtapleural nodule or mass with intense, homogeneous enhancement on computed tomography scans. Herein, we report a case of sclerosing pneumocytoma presenting as main nodule with satellite nodules, mimicking tuberculosis.
Sclerosing pneumocytoma (previously called sclerosing hemangioma) is a rare, benign tumor of the lung with uncertain histogenesis. It is usually seen in middle-aged women [
A 23-year-old woman visited a local hospital with history of blood-tinged sputum for 5 days. She had no previous history of tuberculosis and was a non-smoker. Her chest radiograph revealed a nodular opacity with satellite nodules in the mid zone of the right lung (
Sclerosing pneumocytoma is a rare tumor of the lung that is thought to arise from type II pneumocytes of the respiratory epithelium. This tumor usually occurs in middle-aged adults, with a male-to-female ratio of 1:5 [
In our case, the initial diagnosis considered was an inflammatory lesion, such as tuberculosis or aspergillosis, given the presentation of a heterogeneous primary nodular lesion combined with clustered satellite nodules in a young woman. The probability of a tumor was considered low based on the clinical and radiological findings. The presence of satellite nodules, dumbbell shape, and heterogeneous enhancement was not characteristic of sclerosing pneumocytoma; however, the intense enhancement on contrast CT of 92 HU was suggestive. Sclerosing hemangioma has been reported to manifest as multiple tumors in up to 4% of cases [
In conclusion, sclerosing pneumocytoma generally manifests as a solitary, well-circumscribed nodule or mass. Although very rare, it can present main nodule with surrounding clustered satellite nodules on CT imaging, mimicking active pulmonary tuberculosis.
No potential conflict of interest relevant to this article was reported.
(A) Chest radiograph shows nodular opacity (arrow) with satellite nodules (arrowhead) in the mid zone of the right lung. (B) Precontrast computed tomography (CT) with axial images and mediastinal window settings shows a dumbbell shaped nodule in the superior segment of right lower lobes. (C) Contrast-enhanced CT (2.5-mm reconstruction) with axial images and mediastinal window settings shows a well-enhancing (92 Hounsfield unit) dumbbell shaped nodule with the area of low-attenuation (asterisk) in the superior segment of right lower lobe. (D) Contrastenhanced CT (1-mm reconstruction) with axial images and lung window settings shows clustered satellite nodules on the superior aspect of the primary nodule. (E) Contrast-enhanced CT (2.5-mm reconstruction) with coronal images and lung window setting shows a main nodule (asterisk) with satellite clustered nodules (white arrow) in the superior segment of right lower lobe. (F) 18F-fluorodeoxygloucose positron emission tomography CT reveals that the maximum standardized uptake value of the nodule in the right lower lobe is 2.4 and no other hypermetabolic lesion was detected. (G) Light microscopic image shows a primary nodule consisting of predominantly hypercellular solid component (arrows) and hemorrhagic hemangiomatous component (asterisks) with several satellite nodules (arrowheads) consisting of predominantly solid component in the normal lung parenchyma (H&E stain, ×40).