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- Case Report -

A case of Adenocarcinoma of Lung Resembling to Sclerosing Hemangioma on Microscopic specimens

Noriyuki Takahashi¹, Tamiko Takemura³, Kazunori Tsunematsu², Hiroyuki Sugawara², Shintaro Tanaka², Masanori Fujii² and Tomio Abe^4
1Department of Thoracic Surgery and, ²Department of Internal Medicine, Hokkaido Tomakomai Hospital, ³Department of Pathology, Japanese Red Cross Medical Center, Tokyo, ⁴Second Department of Surgery, Sapporo Medical University, School of Medicine

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Background: It is a matter of common knowledge that pulmonary adenocarcinomas has heterogeneity. While sclerosing hemangioma is thought to have type 2 pneumocyte origin, its histogenesis has not been fully elucidated. We encountered a difficult case in which it was pathologically difficult to make a diagnosis of pulmonary adenocarcinoma or sclerosing hemangioma. Case: A 65-year-old man was admitted due to hemoptysis. He had undergone resection of a squamous cell carcinoma in the left upper lobe more than 2 years previously. Bleeding from a tumor in right S8 caused rapid growth of the tumor on chest X-ray. The resected specimen resembled sclerosing hemangioma on HE staining, however, the final pathologic diagnosis was poorly differentiated pulmonary adenocarcinoma based on overall immunohistochemical findings (CEA, CK, and monoclonal antibody to surfactant apoprotein A) etc.. This was quite an unusual case of pulmonary adenocarcinoma in terms of the clinicopathological findings. Conclusion: Histopathologic findings suggest the case might be a "missing link" between adnocarcinoma and sclerosing hemangioma (pneumocytoma).
key words: Pulmonary adenocarcinoma, Sclerosing hemangioma, Hemorrhage, Heterogeneity, Immunohistochemistry

Received: November 4, 1999
Accepted: July 26, 2000

JJLC 40 (6): 661-665, 2000