Multislice CT features and pathological analysis of pulmonary sclerosing hemangioma

Abstract:

Objective：To discuss the multislice CT（MSCT） findings and pathologic characteristics of pulmonary sclerosing hemangioma（PSH） in order to improve the diagnosis of this disease. Methods：Totally 19 cases of PSH confirmed by operation and histopathology were collected. All cases underwent plain and enhanced CT scan. Retrospective analysis of MSCT features of PSH was done，moreover，the rare but specific CT findings and correlated pathologic basis were discussed. Results：（1）Eighteen cases had isolated lesion and 1 case had 2 lesions，20 lesions in total；among the 20 lesions，11（57.9%） were located in peripheral and 9 in central lung. （2）All lesions were round or oval in shape with well-defined boundary. Lesions of four cases（21.1%） had slight lobulation and lesions of 3 cases（15.8%） had calcification like sand. （3）All lesions were enhanced progressively and persistently at different extents；14 cases（73.7%） showed ‘blood vessel marginating sign’，4 cases（21.1%） showed ‘air meniscus sign’ and 5 cases（26.3%） with round glass opacity around lesions，namely ‘halo sign’. （4）All cases received enhanced scan，5 cases showed marked homogeneous enhancement whereas 14 cases（73.7%） showed intense and patchy heterogeneous enhancement，which was associated with different tissue compo－nents and proportions in hemorrhagic area，papillary area，solid area，sclerotic area of lesions. Conclusions：PSH usually occurs in the middle-aged female patients and locates near lung hilar or lung periphery with isolated lesions round or oval in shape；intense and patchy heterogeneous enhancement of lesions can be seen after enhanced CT scan. ‘Blood vessel marinating sign’，‘halo sign’ and ‘air meniscus sign’ around lesions are highly indicative of PSH，however，pathological check is still needed.