A Malignancy-Mimicking Lung Lesion: Sclerosing Pneumocytoma

Abstract

Abstract Background: Sclerosing pneumocytoma (SP) is a rare benign pulmonary neoplasm that can mimic malignancy on radiologic imaging, presenting a diagnostic challenge. Case: A 56-year-old woman was evaluated for an incidentally detected 30 mm solid mass in the the left lower lobe. PET/CT revealed increased FDG uptake (SUVmax: 5.5), and MRI showed marked contrast enhancement suggestive of a neuroendocrine tumor. Bronchoscopy revealed no endobronchial involvement. Pulmonary function was sufficient for resection. Given the lesion’s central location, imaging findings concerning for malignancy, and absence of a preoperative diagnosis, video-assisted thoracoscopic lobectomy with mediastinal lymph node dissection was performed. Histopathological and immunohistochemical analysis confirmed SP. The postoperative course was uneventful, and no recurrence was observed during 14 months of follow-up. Conclusion: SP should be included in the differential diagnosis of solitary pulmonary nodules. In patients with radiological features mimicking malignancy, anatomical resection may be required for definitive diagnosis and oncological safety.

Keywords

• Lung tumor
• Imaging
• Lobectomy
• Sclerosing pneumocytoma
• Diagnostic challenge

Maligniteyi Taklit Eden Bir Akciğer Lezyonu: Sklerozan Pnömositom

Öz

Özet Giriş: Sklerozan pnömositom (SP), radyolojik olarak maligniteyi taklit edebilen nadir ve benign bir akciğer tümörüdür. Bu nedenle tanısal belirsizliklere yol açabilir. Olgu: Kolesistektomi öncesi yapılan görüntülemede, 56 yaşındaki kadın hastada sol alt lobda 30 mm çapında solid bir kitle saptandı. PET/BT’de SUVmax 5,5 olarak ölçüldü; MR görüntülemede belirgin kontrast tutulumu izlendi. Bronkoskopide endobronşiyal tutulum saptanmadı. Solunum fonksiyon testleri cerrahiye uygun bulundu. Lezyonun santral yerleşimi, radyolojik malignite şüphesi ve preoperatif tanının netleşmemesi nedeniyle, video yardımlı torakoskopik sol alt lobektomi ve mediastinal lenf nodu diseksiyonu uygulandı. Histopatolojik ve immünohistokimyasal inceleme ile SP tanısı doğrulandı. Postoperatif seyir sorunsuzdu ve 14 aylık izlemde nüks gözlenmedi. Sonuç: SP, maligniteyi taklit eden lezyonlarda ayırıcı tanıda göz önünde bulundurulmalıdır. Malignite şüphesi taşıyan olgularda anatomik rezeksiyon, tanı ve onkolojik güvenlik açısından uygun bir yaklaşımdır.

Anahtar Kelimeler

• Akciğer tümörü
• Görüntüleme
• Lobektomi
• Sklerozan pnömositom
• Tanı zorluğu

Kaynakça

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