Analysis of the clinical differentiation of pulmonary sclerosing pneumocytoma and lung cancer.

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Analysis of the clinical differentiation of pulmonary sclerosing pneumocytoma and lung cancer.

J Thorac Dis. 2017 Sep;9(9):2974-2981

Authors: Zhu J

Abstract
Background: Pulmonary sclerosing pneumocytoma (PSP) is a rare benign lung tumor. This study investigated the diagnostic experience of PSP and lung cancer.
Methods: This study is a retrospective study. We observed the locations of lung lesions, imaging form and clinical symptoms, and recorded the surgical complications through comparing patients with PSP and lung cancer.
Results: From December 2012 to February 2017, 187 PSP cases and 197 lung cancer cases were collected. PSP was commonly found in women (88.2%), often occurred in the left lower lobe (32.6%), and was associated with a lesion size of 10-20 mm (48.7%). PSP patients presented with cough, sputum, chest pain, and most patients had a single lesion, which could showed no clear boundary. Most PSP patients exhibited no enlargement of mediastinal lymph nodes, had no involvement of the blood vessels, and had low computed tomography (CT) values (low Hounsfield units). Lung cancers were more commonly found in men (69.0%), with the lesions scattered throughout all lobes of the lung. Cases with a tumor size >30 mm accounted for 76.2% of patients. Lung cancer patients also presented systemic symptoms, and the tumors were found to have unclear boundaries. Moreover, patients presented with enlarged mediastinal lymph nodes, high CT values, and heterogeneous internal tumor texture.
Conclusions: This study showed that PSP was rare and difficult to differentiate from lung cancer. PSP was often found in 40-70-year-old non-smoking women and most patients presented with cough and sputum. Patients often had a single lesion, which was commonly located in the left lower lobe and could have unclear boundaries. The majority of patients exhibited no enlargement of mediastinal lymph nodes and had low CT values. Therefore, our results can provide some basis for the differential diagnosis of PSP and lung cancer.

PMID: 29221270 [PubMed]

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