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Case report
Unexpected diagnosis of multiple sclerosing pneumocytomas in a patient with chondrosarcoma of the hand
  1. Sven L Van Laer1,2,
  2. Annelore Vandendriessche3,2,
  3. Johan Somville4,2 and
  4. Paul E Van Schil1,2
  1. 1Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Edegem, Antwerp, Belgium
  2. 2Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium
  3. 3Department of Pathology, University Hospital Antwerp, Edegem, Antwerp, Belgium
  4. 4Department of Orthopaedic Surgery, University Hospital Antwerp, Edegem, Antwerp, Belgium
  1. Correspondence to Professor Paul E Van Schil; Paul.Van.Schil{at}uza.be

Abstract

Sclerosing pneumocytomas are rare, benign pulmonary neoplasms that predominantly affect Asian female patients in the age category of 40–70 years, mostly non-smokers. We report on a 72-year-old Caucasian woman with chondrosarcoma of the hand who developed multiple bilateral progressive lung nodules suspicious of lung metastases. Staged lung resections were performed, and pathological diagnosis was confirmed by immunohistochemical analysis of the resected specimens. Next-generation sequencing (NGS) was used to detect gene mutations. Immunohistochemistry demonstrated sclerosing pneumocytomas, and NGS showed an IDH1 mutation. Eventually, the patient developed lung metastases for which rethoracotomy was performed. The differentiation of sclerosing pneumocytoma from lung cancer is a diagnostic challenge, and sclerosing pneumocytoma should be considered in the differential diagnosis of pulmonary nodules. Gene mutation analysis does not always show classical and common mutations, which should be kept in mind when interpreting its results.

  • cardiothoracic surgery
  • lung cancer (oncology)
  • pathology
  • respiratory medicine
  • cancer intervention

https://doi.org/10.1136/bcr-2020-238375

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    Footnotes

    • Contributors SLVL wrote the original draft, contributed to the conceptualisation and visualisation of the article, and spoke to and consented the patient’s daughter. AV and JS contributed to the writing of the original draft, the conceptualisation and visualisation of the article. PEVS contributed to the conceptualisation, supervised the writing of the article and critically reviewed the article for intellectual content. All authors have read and approved the submission of the final manuscript to BMJ Case Reports and have agreed to be accountable for the article regarding its accuracy and integrity.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.