Sclerosing hemangioma with florid endobronchial and endobronchiolar growth

Abstract

Sclerosing hemangioma (SH) with endobronchial growth (SH-EG) is an extremely unusual form of SH. A case of SH-EG in a 47-year-old female is described. She suffered from a productive cough for 4 months. A chest CT scan revealed a well-circumscribed, parenchymal mass with endobronchial lesions continuously extending to the right main bronchus. Right upper sleeve lobectomy was carried out. The tumor was 4.8 × 3.5 cm in size, tan-brown, and elastically soft. It was located in the pulmonary parenchyma of the right upper lobe and continuously extended to the right upper bronchus. Furthermore, the main tumor also spread into segmental bronchi and peripheral bronchioles. Microscopically, the tumor consisted of round to cuboidal cells with papillary and solid patterns, partly showing sclerosis and hemorrhage. For 2.5 years after surgery, the patient has been well without recurrence or metastasis. Florid intrabronchial extension as seen in this case has never been documented in SH. To form an endobronchial component, it seems to be crucial that the parenchymal SH is located adjacent to the bronchus and involves it, followed by the destruction of the bronchial cartilage.