Articles Vol. 65 No. CĐ 3 - Bệnh viện Phổi Trung ương 15/05/2024

38. PITFALLS IN HISTOPATHOLOGICAL DIAGNOSIS OF SCLEROSING PNEUMOCYTOMA ON SMALL BIOPSY AND FROZEN SECTION SPECIMENS: PRACTICAL EXPERIENCE AT PATHOLOGY DEPARTMENT, NATIONAL LUNG HOSPITAL FROM 2021 TO 2023

Tran Thi Tuan Anh1,2, Duong Minh Phuong1,2, Le Trung Tho1,2,3,4
1 National Lung Hospital
2 Bệnh viện Phổi Trung ương
3 Hanoi Medical University
4 Trường Đại học Y Hà Nội
Corresponding author: Drtrananhbvp@gmail.com
DOI: 10.52163/yhc.v65iCD3.1135
15 Views
9 Downloads
Abstract

Background: National Lung Hospital is a leading hospital specializing in respiratory diseases and thoracic surgery in Vietnam. The opportunity to access the diagnosis of lung nodules such as sclerosing pneumocytoma (SP) is quite common. This is a rare benign tumor in the lung. The tumor originates from pneumocyte and its histopathological features also create many pitfalls that are easily confused with highly differentiated adenocarcinoma.

Objective: To share experiences in histopathological diagnosis to avoid pitfalls when diagnosing sclerosing pneumocytoma at the Pathology Department – National Lung Hospital from 2021 to 2023, especially small biopsies and frozen section specimens.

Results: Report of 3 cases of sclerosing pneumothorax that were operated on at the National Lung Hospital with distinguishing features in clinical, imaging, small biopsy histology or frozen section specimens, differentiated from adenocarcinoma.

Conclusion: With SP, clinical symptoms and imaging diagnoses are non-specific, and diverse histopathological morphology will create challenges when diagnosing, with the risk of confusion with consolidation lesions or malignant tumors, lead to errors in treatment and prognosis. The physians need to accumulate knowledge and practice experience to avoid these pitfalls.

References
[1]
Gong Y et al., Pulmonary sclerosing pneumocytoma: Google Scholar
[2]
A comprehensive review. Archives of Pathology & Google Scholar
[3]
Laboratory Medicine. 2018(142(11)):1328-34. Google Scholar
[4]
Jin Y et al., Clinical and imaging characteristics Google Scholar
[5]
of pulmonary sclerosing pneumocytoma: A retrospective Google Scholar
[6]
analysis. BMC Pulmonary Medicine.2021(21(1)):1-7. Google Scholar
[7]
Chang JC et al., Pulmonary sclerosing pneumocytoma: Google Scholar
[8]
Imaging features and diagnostic challenges. Radiology. Google Scholar
[9]
(292(2)):356-64. Google Scholar
[10]
Wang L et al., Diagnostic value of CT features Google Scholar
[11]
in the differentiation of pulmonary sclerosing Google Scholar
[12]
pneumocytoma from peripheral lung adenocarcinoma Google Scholar
[13]
smaller than 3 cm in diameter. Cancer Google Scholar
[14]
Imaging. 2017;17(1):1-7. Google Scholar
[15]
Board WCoTE, World Health Organization classification Google Scholar
[16]
of tumours: Thoracic tumours - Fifth Google Scholar
[17]
edition. Board WCoTE, editor. Lyon: World Google Scholar
[18]
Health Organization; 2021. Google Scholar
[19]
Le HY PD, Nguyen KT et al., Pulmonary sclerosing Google Scholar
[20]
pneumocytoma in an 18-year-old male Google Scholar
[21]
patient: A case report and literature review. Medicine Google Scholar
[22]
(Baltimore). 2020;99(26):e20869. Google Scholar
[23]
Nguyen HH et al., Pulmonary sclerosing pneumocytoma: Google Scholar
[24]
A case report and literature review." Vietnamese Journal Google Scholar
[25]
of Cancer Medicine.2021;15(3):23-8. Google Scholar
[26]
Cung Văn Công, U phế bào xơ hoá - Báo cáo Google Scholar
[27]
trường hợp và xem xét tài liệu liên quan. Journal of Google Scholar
[28]
- Clinical Medicine and Phamarcy.2023;17(8). Google Scholar
[29]
Tran VT et al., Management of pulmonary sclerosing Google Scholar
[30]
pneumocytoma: A case series, Journal of Google Scholar
[31]
Thoracic Disease. 2019;11(10):4183-9. Google Scholar
[32]
Kocaman GYM, Ersöz CC et al., Pulmonary Google Scholar
[33]
sclerosing pneumocytoma with mediastinal Google Scholar
[34]
lymph node metastasis: A case report. Gen Thorac Google Scholar
[35]
Cardiovasc Surg. 2021;69(1):142-6. Google Scholar
[36]
Zheng QZJ, Li G et al., Pulmonary sclerosing Google Scholar
[37]
pneumocytoma: Clinical features and prognosis.. Google Scholar
[38]
World J Surg Oncol. 2022; 20(1):140. Google Scholar
[39]
Luca Cima MD, Sherman L, Matthew J et al., Google Scholar
[40]
Lung - Papillomas and adenomas - Sclerosing Google Scholar
[41]
pneumocytoma 2023 [Available from: Https:// Google Scholar
[42]
www.pathologyoutlines.com/topic/lungtumorsclerosingheman.html. Google Scholar
[43]
Lester J, Layfield ZB, The Papanicolaou Society Google Scholar
[44]
of Cytopathology System for Reporting Respiratory Cytology: Google Scholar
[45]
Definitions, Criteria, Explanatory Notes, and Recommendations Google Scholar
[46]
for Ancillary Testing, 2019. Google Scholar
[47]
Lee HSKJ, Moon DH et al., Huge Pulmonary Google Scholar
[48]
Sclerosing Pneumocytoma with Endobronchial Google Scholar
[49]
Invasion: A Case Report with a Literature Review. Google Scholar
[50]
J Chest Surg. 2021;54(6):528-31. Google Scholar
[51]
Maleki ZMS, Layfield L et al., Pulmonary Google Scholar
[52]
sclerosing pneumocytoma: Cytomorphology and Google Scholar
[53]
immunoprofile. Cancer Cytopathol. Google Scholar
[54]
;128(6):414-23. Google Scholar
[55]
Zhang WDSZ, Zhang MY, Yin YH et al., Giant Google Scholar
[56]
pulmonary sclerosing pneumocytoma with potentially Google Scholar
[57]
malignant biological behavior: A case report and Google Scholar
[58]
literature review. Ann Transl Med.2023;30:365. Google Scholar