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Pulmonary Sclerosing Hemangioma Manifesting as a Nodule with Irregular Air Clefts on High-Resolution CT

Hiroshi Takatani1, Kazuto Ashizawa2, Kiyoko Kawai3 and Shigeru Kohno4

1 Department of Internal Medicine, Nagasaki Municipal Hospital, Nagasaki 852-8555, Japan.
2 Department of Radiology and Radiation Oncology, Nagasaki University Graduate School of Biomedical Science and Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
3 Department of Pathology, Nagasaki Municipal Hospital, Nagasaki, Japan.
4 Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan.


Figure 1
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  		Fig. 1A —42-year-old woman with pulmonary sclerosing hemangioma over 6-year follow-up period. Magnified view of initial chest radiograph in 1997 reveals solitary pulmonary mass in left upper lung field.

 

Figure 2
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  		Fig. 1B —42-year-old woman with pulmonary sclerosing hemangioma over 6-year follow-up period. Initial chest CT image in 1997 shows well-defined mass with irregular air spaces (arrowheads) in left upper lobe. Emphysematous change (black arrows) and ground-glass opacity (GGO) (white arrows) are also seen in surrounding lung parenchyma.

 

Figure 3
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  		Fig. 1C —42-year-old woman with pulmonary sclerosing hemangioma over 6-year follow-up period. High-resolution CT (HRCT) image obtained in 2000 when patient experienced hemoptysis shows increase in area of GGO (arrows) around mass.

 

Figure 4
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  		Fig. 1D —42-year-old woman with pulmonary sclerosing hemangioma over 6-year follow-up period. HRCT image obtained at admission in 2003 when patient was again experiencing hemoptysis shows air spaces (arrowheads) within mass have spread like ground cleft, area of GGO (white arrows) extends to pleural surface, and emphysematous change (black arrows) around mass is more marked.

 

Figure 5
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  		Fig. 1E —42-year-old woman with pulmonary sclerosing hemangioma over 6-year follow-up period. Histopathologic specimen shows hemorrhagic and solid pattern with hyalinization. Irregularly enlarged cystic air spaces lined by cuboidal epithelial cells are present in solid proliferation of epithelioid tumor cells. (H and E, x100)

 

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