Placental transmogrification of the lung: two case report and systematic review of the literature

Abstract

Objective Placental transmogrification of the lung(PTL) is rare; summarizes the reported cases and add our two cases, to explore the best diagnosis and treatment strategy. Methods Review of the cases reported in the literature, combined with the 2 cases described in this article, summarizes the characteristics of PTL and analyzed the best diagnosis and treatment strategy. Results We reported two cases of placental transmogrification of the lung, both presented in the right lower lobe, imaging performance as a giant bulla with a cystic nodule. VATS lobectomy was performed in both cases, no complication after operation. Combined with literature review of 34 cases of patients to analyze the best diagnosis and treatment strategy. Conclusion Grossly and microscopically, the lesion resembles placental tissue, with formation of placental villus-like papillary structures covered by epithelial cells. The most common imaging manifestation of PTL is a bullous emphysema pattern or with a mixed pattern of thin-walled cystic lesions and nodules. Early diagnosis and surgical operation should be performed as soon as possible, these lesions are best treated by minimally invasive surgery, leaving as much normal lung tissue and avoiding pneumonectomy if possible. Surgical treatment is usually curable and leads to successful improvement of symptoms and quality of life. Key words: Placental transmogrification of the lung; Bullous emphysema; Image feature; Pathology feature; Thoracic surgical procedures