Lung Cancer: Lung Cancer I |

Sclerosing Hemangioma of the Lung: Frozen Section Diagnosis Based on an Analysis of the Varied Appearances in a Series of Thirteen Cases From a Single Institution FREE TO VIEW

Jiping Da, MD; Ling Zhao, MD; Eugene J. Mark, MD
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China-Japan Friendship Hospital, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A296. doi:10.1016/j.chest.2016.02.309
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Sclerosing hemangioma (SH) of the lung is a rare neoplasm with polymorphic histologic features. The frozen section diagnosis of SH can be difficult, as it can be confused for malignancy. To improve the situation on intraoperative dilemmas for pathologists, we retrospectively analyzed a series of thirteen cases of pulmonary sclerosing hemangioma diagnosed on frozen sections.

METHODS: Thirteen cases surgically resected SH tissue specimens and correlated with patients’ clinicopathologic characteristics in China-Japan Friendship Hospital from 2009 to 2014. Both pathologists reviewed all frozen sections and paraffin sections, and immunohistochemical staining for TTF-1, Napsin A, Vimentin, EMA, CK7, CK20, CD31, F8 was performed.

RESULTS: We characterized the predominant patterns: solid, papillary, haemorrhagic or sclerotic. Two or more patterns were identified in twelve cases. One case exhibited only papillary pattern. A frozen section diagnosis of ‘sclerosing hemangioma’ was reported in ten cases, and ‘benign lesion’ was given in one case. Because of technical artifact and the uncommon morphology, the diagnosis was deferred in two cases. Significant cytological atypia was present in one case. Because sclerosing hemangioma is a benign tumor, accurate frozen diagnosis may avoid unnecessarily excessive surgery.

CONCLUSIONS: Awareness of its varied patterns and distinctive cytological features, together with careful gross examination and sampling may help to avoid a diagnosis of malignancy and lead to conservative management.

CLINICAL IMPLICATIONS: To avoid the overdiagnosis caused by pitfalls.

DISCLOSURE: The following authors have nothing to disclose: Jiping Da, Ling Zhao, Eugene J. Mark

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