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Respiratory medicine
Pulmonary sclerosing pneumocytoma – approaching a solitary pulmonary nodule and the limitations of risk prediction models
  1. Kundan Reddy Saripalli1,
  2. Mark Qi Wei Wang2,
  3. Chun Yuen Chow3 and
  4. Si Yuan Chew1
  1. 1Department of Respiratory and Critical Care Medicine, SingHealth Group, Singapore
  2. 2Department of Vascular and Interventional Radiology, SingHealth Group, Singapore
  3. 3Department of Anatomical Pathology, SingHealth Group, Singapore
  1. Correspondence to Dr Kundan Reddy Saripalli; kundan.saripalli{at}mohh.com.sg

Abstract

Our case is an asymptomatic, non-smoking, East Asian woman in her 40s presenting with a solitary pulmonary nodule (SPN). On imaging, the 1.7 cm solid SPN located in the left upper lobe, was rounded in morphology and moderately fluorodeoxyglucose avid. The clinical pretest probability of malignancy assessed by risk prediction models such as Brock (19.1%), Mayo Clinic (56.2%) and Herder (51.4%) was discordant. She underwent a percutaneous CT-guided needle biopsy, establishing a diagnosis of pulmonary sclerosing pneumocytoma (PSP). PSP is a rare benign lung neoplasm with indolent growth characteristics that has been described predominantly in non-smoking women. Our case illustrates the limitations of applying existing risk prediction models in Asia where the epidemiology and biology of lung cancer differ significantly from the Caucasian derivation cohorts. Additionally, the risk models do not account for tuberculosis, which is endemic in Asia and can mimic malignancy. Non-surgical lung biopsy remains useful in minimising unnecessary thoracotomy.

  • Lung cancer (oncology)
  • Respiratory cancer
  • Medical management
  • Statistics and research methods

https://doi.org/10.1136/bcr-2023-257208

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    Footnotes

    • Presented at Poster abstract presented at Asia Pacific Society of Respirology Congress 2022 held at Seoul, South Korea

    • Contributors The following authors were responsible for drafting of the text and drawing original diagrams and algorithms: KRS and SYC. The following authors were responsible for sourcing and editing of clinical images, investigation results: MQWW and CYC. The following authors were responsible for critical revision for important intellectual content: KRS, MQWW, CYC and SYC. The following authors were responsible for revision after reviewer comments: KRS and SYC. The following authors gave final approval of the manuscript: KRS, MQWW, CYC and SYC.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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