EURORAD ESR

Case 11242

A rare cause of bilateral pulmonary nodules

Author(s)
Mesquita R, Sousa M, Ananias P, Lopes P, Costa N, Ribeiro A, Figueiredo L

Hospital de Santa Marta,
Centro Hospitalar Lisboa Central,
Radiologia;
Rua de Santa Marta, Lisboa, Portugal;
Email:romeu.mesquita@gmail.com
 
Patient
male, 35 year(s)
 
 
  • Figure 1
    Posteroanterior and lateral chest X-rays
     

    The chest radiograph showed a diffuse micronodular pattern in both lungs.

     
    Area of Interest: Thorax; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    The chest radiograph showed a diffuse micronodular pattern in both lungs.

     
    Area of Interest: Thorax; Imaging Technique: Digital radiography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    Chest CT
     

    Multislice chest CT-images on lung window showed innumerous, well-defined, small, round and noncalcified pulmonary nodular opacities, scattered in both lungs.

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    These nodules were present in all pulmonary lobes and typically adjacent to bronchioles and medium/small vessels.

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Contrast-enhanced multislice CT of the chest on mediastinal window showed no thoracic lymphadenopathy.

     
    Area of Interest: Thorax; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 3
    Liver CT
     

    Multislice abdominopelvic CT with intravenous contrast admninistration showed no significant findings, excluding focal liver lesions.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Multislice abdominopelvic CT with intravenous contrast admninistration showed no significant findings, excluding focal liver lesions.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 4
    Histopathologic findings of haemangioendothelioma
     

    Low-magnification of the specimen obtained from pulmonary wedge resection reveals a sub-pleural nodule that extends to adjacent alveoli, with vascular proliferation in the peripheral zone and areas of recent and old...

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Biopsy; Special Focus: Neoplasia;

    Neoplastic nodule showing tumour cells with an eosinophilic stroma at the periphery. The lesion contains blood filled spaces and respiratory epithelium “trapped” within the lesion.

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Biopsy; Special Focus: Neoplasia;

    Higher magnification of the tumour reveals vacuolation of some of the tumour cells, representing primitive angiogenesis. One of these epithelioid cells can be observed, with intracytoplasmic lumen and an erythrocyte...

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Biopsy; Special Focus: Neoplasia;

    Immunostaining for CD34 revealed positivity of the neoplastic cells (brown colour), confirming the endothelial lineage of the tumour.

     
    Area of Interest: Lung; Imaging Technique: Experimental; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
The chest radiograph showed a diffuse micronodular pattern in both lungs.
 
The chest radiograph showed a diffuse micronodular pattern in both lungs.
 
Multislice chest CT-images on lung window showed innumerous, well-defined, small, round and noncalcified pulmonary nodular opacities, scattered in both lungs.
 
These nodules were present in all pulmonary lobes and typically adjacent to bronchioles and medium/small vessels.
 
Contrast-enhanced multislice CT of the chest on mediastinal window showed no thoracic lymphadenopathy.
 
Multislice abdominopelvic CT with intravenous contrast admninistration showed no significant findings, excluding focal liver lesions.
 
Multislice abdominopelvic CT with intravenous contrast admninistration showed no significant findings, excluding focal liver lesions.
 
Low-magnification of the specimen obtained from pulmonary wedge resection reveals a sub-pleural nodule that extends to adjacent alveoli, with vascular proliferation in the peripheral zone and areas of recent and old haemorrhage.
 
Neoplastic nodule showing tumour cells with an eosinophilic stroma at the periphery. The lesion contains blood filled spaces and respiratory epithelium “trapped” within the lesion.
 
Higher magnification of the tumour reveals vacuolation of some of the tumour cells, representing primitive angiogenesis. One of these epithelioid cells can be observed, with intracytoplasmic lumen and an erythrocyte inside, indicating their vascular nature.
 
Immunostaining for CD34 revealed positivity of the neoplastic cells (brown colour), confirming the endothelial lineage of the tumour.
 
 
 
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