Pulmonary sclerosing hemangioma : correlation of radiographic and pathologic findings

Abstract

Objective To study the radiographic features of pulmonary sclerosing hemangioma (PSH), and to correlate the imaging with the pathologic findings so as to improve the imaging diagnostic abilities. Methods The clinical features of 45 patients with pathology proved PSH between 1976 and 2002 were reviewed. Of the 45 patients, there were 3 men and 42 women, their age ranged from 18 to 67 years (median age, 49 years), and 19 patients were asymptomatic. 20 patients had chest radiography and CT scans. The radiographic findings were studied retrospectively and were correlated with that of pathology. (7 patients) underwent unenhanced CT and 13 patients had enhanced CT. Results Of the 20 patients who had chest X-ray, 18 patients presented as a solitary, round or oval shaped lesion with well-defined margin. On CT scans, the greatest dimension of the lesion ranged from 1.9 cm to 7.0 cm. A homogeneous soft-tissue attenuation was revealed on unenhanced scans. Homogeneous enhancement was detected in 9 patients and heterogeneous enhancement in 4 patients on enhanced CT. Cystic change was found in 1 patient showing lower attenuation than the enhanced solid tumor, and calcification was found in 5 patients. Correlation of radiographic and pathologic findings indicated that higher attenuation areas corresponded to the angiomatous areas. Conclusions PSH should be considered with the following features: (1) female patients between (40-60) years of age; (2) well-defined round or oval shaped lesion on chest radiography; (3) a homogeneous soft-tissue mass on unenhanced CT; cystic-like area within the tumor and/or calcification can occasionally be found; (4) homogeneous or heterogeneous enhancement after contrast administration.