SCLEROSING HEMANGIOMAS OF LUNG - A CASE REPORT AND REVIEW OF LITERATURE

Abstract

Sclerosing hemangioma of the lung occurs Dredominantly in females, at a ratio of about 21 and is most commonly observed in the 4th and 5th decades of life. Hemoptysis is the most common presenting finding, and a cough which may or may not be productive with a history of past or recent respiratory infections is frequently present. Roentgenograms of the chest usually reveal a solitary, lobulated, wellcircumscribed mass most commonly in the right lower or left upper lung field. There is usually no evidence of calcification or cavitation, and no infiltration of the surrounding lung. On gross examination the sclerosing hemangioma is a lobulated mass with a sharply defined border which does not infiltrate the surrounding lung parenchyma. The overlying pleura is usually not involved, and the average size is approximately 3 to 5 cm. The consistency of these tumors is usually soft and gelatinous, and their color is gray or yellow with areas of hemorrhage. Histologically, sclerosing hemangiomas are characterized by a conglomeration of spindle-shaped cells with abundant acidophilic cytoplasm and elongated nuclei. These cells are frequently arranged in whorls or sheaths. Vascular channels are conspicuous throughout and vary considerably in size. Throughout the tumor, focal accumulations of fat-laden macrophages may be seen, and there are usually areas of recent and old hemorrhage. The neoplasm may infiltrate the wall of adjacent bronchi, but they do not show direct invasion of the bronchial mucosa. Also, infiltration of pulmonary vessels has not been noted. Sclerosing hemangioma of the lung appears to be a benign tumor which runs a slow, relatively benign course but, because of its clinical manifestations, location, and roentgenographic findings, surgical exploration and excision are mandatory.