Pulmonary sclerosing hemangioma with pleural dissemination: Report of a case

Suzuki, Hidemi; Saitoh, Yukio; Koh, Eitetsu; Hoshino, Hidehisa; Kase, D J; Kasei, Yoshihiko; Azuhata, Yasuji; Kishi, Hirohisa; Hiroshima, Kenzo; Sekine, Yasuo

doi:10.1007/s00595-009-4220-5

Cited by 28 publications

(31 citation statements)

References 15 publications

(15 reference statements)

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“…In a previous study, we performed clonality analysis using the X-linked androgen receptor and phosphoglycerate kinase gene polymorphisms, and the results revealed that this tumor is a true neoplasm rather than a tumor-like lesion [9]. However, the biological behavior of this tumor and differentiation status of the two types of cells is still controversial [10,11,[13][14][15][16]. The cuboidal and polygonal cells significantly differ in histological pattern, cellular morphology, and even immunophenotype, but our previous study indicated that they have the same origin [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…If the polygonal cells are in an immature status, they might be in an active state of proliferation. Although most scholars believe that the tumor is benign, there are reports of lymph node metastasis [13,14], pleural dissemination [15], and metastatic spread to the stomach [16]. These findings have prompted us to study the differentiation status of the two types of cells and the clinical behavior of PSH.…”

Section: Introductionmentioning

confidence: 99%

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In pulmonary sclerosing hemangioma expression of β-catenin, Axin, and C-myc differs between the two cell types

Lin

Zhang

et al. 2012

Virchows Arch

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Previous studies have shown that pulmonary sclerosing hemangioma is a tumor derived from primitive respiratory epithelium, but its character and the differentiation status of the two cell types (polygonal and cuboidal) composing the lesion are still controversial. We hypothesize that the polygonal cells are immature compared with cuboidal cells and have higher proliferative activity. To further study this question, we examined the expression of β-catenin, Axin, and C-myc by immunostaining in 45 primary sclerosing hemangioma (PSH) specimens. The two cell types were captured by laser capture microdissection from 28 PSH specimens, and total RNA was extracted. Messenger RNA (mRNA) expression of Axin and C-myc was examined by reverse transcription polymerase chain reaction (RT-PCR). By immunostaining, β-catenin was predominantly strongly expressed on the cell membrane of cuboidal cells, while in polygonal cells, β-catenin was predominantly expressed in the cytoplasm and significantly decreased on cell membranes. Axin was expressed in cuboidal cells in 93 % of our 45 cases, but only expressed in 18 % of these in polygonal cells. C-myc expression in polygonal cells was significantly stronger than in cuboidal cells (P < 0.05). RT-PCR showed that the expression level of Axin mRNA in cuboidal cells was significantly higher than in polygonal cells (P < 0.05), and expression level of C-myc mRNA in polygonal cells was significantly higher than in cuboidal cells (P < 0.05).The two PHS cell types have distinct expression of β-catenin, Axin, and C-myc, suggesting that their differentiation status may be different. The higher expression of C-myc in polygonal cells suggests that these cells might have higher proliferative activity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

In pulmonary sclerosing hemangioma expression of β-catenin, Axin, and C-myc differs between the two cell types

Lin

Zhang

et al. 2012

Virchows Arch

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“…It typically affects middle-aged adults with female predominance, presents as a solitary and slow growing mass located in the lung periphery, demonstrating a benign clinical course [8]. However, occasional recurrence and progressive pleural dissemination in post-operative follow-up of PSH patients have been previously reported [10,11]. Regional lymph node metastasis and rare locally infiltrative growth to pleura may suggest low malignant potential for the minority of PSH [10-13].…”

Section: Discussionmentioning

confidence: 99%

“…However, occasional recurrence and progressive pleural dissemination in post-operative follow-up of PSH patients have been previously reported [10,11]. Regional lymph node metastasis and rare locally infiltrative growth to pleura may suggest low malignant potential for the minority of PSH [10-13]. Histologically, PSH consists of two types of tumor cells, the surface cuboidal cells and the round stromal cells, forming a mixture of sclerotic, hemorrhagic, papillary and solid patterns.…”

Section: Discussionmentioning

confidence: 99%

A mixture of carcinoid tumors, extensive neuroendocrine proliferation, and multiple pulmonary sclerosing hemangiomas

Wang

Shi

et al. 2014

World J Surg Onc

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We encountered an extremely rare case of multiple pulmonary sclerosing hemangiomas (PSH) with extensive neuroendocrine lesions, including pulmonary neuroendocrine cell (PNC) hyperplasia, multiple carcinoid tumorlets and typical carcinoid tumors within one pulmonary lobe. To the best of our knowledge, this is the first reported case in the English medical literature of PSH combined and admixed with carcinoid tumors and extensive neuroendocrine proliferation. This case is noteworthy for several reasons. First, the lesion is multi-nodular and unusually large for a typical PSH, which may mimic malignancy on imaging studies and cause diagnostic difficulties. Second, sampling bias may lead to diagnostic errors for a lesion containing two different types of neoplasms. Third, our case displays a rare mixed and mosaic pattern of PSH with a full spectrum of pulmonary neuroendocrine lesions, which may imply a potential intrinsic association in pathogenesis between PSH and concomitant neuroendocrine neoplasms. The clinical implication of multiple PSHs is also discussed.

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“…Although many scholars believe that the tumor is benign, there are reports of lymph node metastasis [10,11], pleural dissemination [12], and metastatic spread to the stomach [13]. So, some authors advocate it may belong to be a tumor with low malignant potential [14].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary sclerosing hemangioma presenting with dense spindle stroma cells: a potential diagnostic pitfall

et al. 2012

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Pulmonary sclerosing hemangioma (PSH) is an uncommon pulmonary tumor. Histologically, PSH typically consists of two types of cells, surface cuboidal cells and polygonal cells, four architectural patterns including papillary, sclerotic, solid, and hemorrhagic. Herein, we present a case of PSH in a 59-year-old Chinese female. The tumor was predominantly composed of solid area presenting with diffuse spindle cells rather than polygonal cells. Focally, classical papillary and sclerotic area could be seen. Immunohistochemical staining showed that the spindle cells were positive for TTF-1, EMA, Actin(SM) and Vimentin, and negative for cytokeratin, cytokeratin7, cytokeratin5/6, surfactant apoprotein A, surfactant apoprotein B, CD34, CD99, S-100, HMB45, Desmin, Synaptophysin, CD56, ALK and Calretinin. The immunophenotype of the dense spindle cells in this case was similar to that of the polygonal cells, and thus the spindle cells may be the variants of polygonal cells. Based on morphologic features and the immunohistochemical profile, the tumor was diagnosed as a PSH. The significance of spindle cells change is unclear for us. To our knowledge, this is the first reported case of PSH showing dense spindle cells in solid area. This case represents a potential diagnostic pitfall, as it may be misdiagnosed as a mesenchymal tumor such as inflammatory myofibroblastic tumor, synovial sarcoma, solitary fibrous tumor, leiomyoma, or even mesothelioma, especially if the specimen is limited or from fine- needle aspiration.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1235401622806126

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Pulmonary sclerosing hemangioma with pleural dissemination: Report of a case

Cited by 28 publications

References 15 publications

In pulmonary sclerosing hemangioma expression of β-catenin, Axin, and C-myc differs between the two cell types

In pulmonary sclerosing hemangioma expression of β-catenin, Axin, and C-myc differs between the two cell types

A mixture of carcinoid tumors, extensive neuroendocrine proliferation, and multiple pulmonary sclerosing hemangiomas

Pulmonary sclerosing hemangioma presenting with dense spindle stroma cells: a potential diagnostic pitfall

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