Pulmonary sclerosing pneumocytoma - approaching a solitary pulmonary nodule and the limitations of risk prediction models.
Kundan Reddy SaripalliMark Qi Wei WangChun Yuen ChowSi Yuan ChewPublished in: BMJ case reports (2023)
Our case is an asymptomatic, non-smoking, East Asian woman in her 40s presenting with a solitary pulmonary nodule (SPN). On imaging, the 1.7 cm solid SPN located in the left upper lobe, was rounded in morphology and moderately fluorodeoxyglucose avid. The clinical pretest probability of malignancy assessed by risk prediction models such as Brock (19.1%), Mayo Clinic (56.2%) and Herder (51.4%) was discordant. She underwent a percutaneous CT-guided needle biopsy, establishing a diagnosis of pulmonary sclerosing pneumocytoma (PSP). PSP is a rare benign lung neoplasm with indolent growth characteristics that has been described predominantly in non-smoking women. Our case illustrates the limitations of applying existing risk prediction models in Asia where the epidemiology and biology of lung cancer differ significantly from the Caucasian derivation cohorts. Additionally, the risk models do not account for tuberculosis, which is endemic in Asia and can mimic malignancy. Non-surgical lung biopsy remains useful in minimising unnecessary thoracotomy.
Keyphrases
- pulmonary hypertension
- ultrasound guided
- computed tomography
- positron emission tomography
- high resolution
- fine needle aspiration
- case report
- magnetic resonance imaging
- risk factors
- minimally invasive
- african american
- heart failure
- type diabetes
- mass spectrometry
- pregnant women
- metabolic syndrome
- pregnancy outcomes
- adipose tissue
- magnetic resonance
- aortic valve replacement
- pulmonary tuberculosis
- aortic valve
- photodynamic therapy