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Central and peripheral pulmonary sclerosing pneumocytomas: multi-phase CT study and comparison with Ki-67 Cover

Central and peripheral pulmonary sclerosing pneumocytomas: multi-phase CT study and comparison with Ki-67

Radiology and Oncology
Volume 57 (2023): Issue 3 (September 2023)
By: Yanli Zhang,  Chao Ran and  Wei Li  
Open Access
|Sep 2023

Figures & Tables

FIGURE 1.

Multi-phase contrast-enhanced CT of central PSP with higher Ki-67 index. Axial unenhanced CT image revealed a roundish isodense lesion in the left perihilar region with a CT density of 49 Hu (A). After administration of contrast medium, the lesion showed inhomogeneous enhancement with the enlarged left inferior pulmonary artery and overlying vessel sign (B). The lesions showed progressive and continuous enhancement in the arterial phase (75 Hu) (B), venous phase (96 Hu) (C), and delayed phase (110 Hu) (D). Immunohistochemical staining showed the Ki-67 reactive tumor cells accounted for about 10% (× 400) (E).
Multi-phase contrast-enhanced CT of central PSP with higher Ki-67 index. Axial unenhanced CT image revealed a roundish isodense lesion in the left perihilar region with a CT density of 49 Hu (A). After administration of contrast medium, the lesion showed inhomogeneous enhancement with the enlarged left inferior pulmonary artery and overlying vessel sign (B). The lesions showed progressive and continuous enhancement in the arterial phase (75 Hu) (B), venous phase (96 Hu) (C), and delayed phase (110 Hu) (D). Immunohistochemical staining showed the Ki-67 reactive tumor cells accounted for about 10% (× 400) (E).

FIGURE 2.

Multi-phase contrast-enhanced CT of peripheral PSP with lower Ki-67 index. Axial unenhanced CT image revealed a peripheral isodense nodule in the right upper lobe with a CT density of 46 Hu (A). After administration of the contrast medium, the lesions showed homogeneous enhancement. The lesion showed progressive and continuous enhancement in the arterial phase (73 Hu) (B) and venous phase (102 Hu) (C), with a certain enhancement washout in the delayed phase (87 Hu) (D). Immunohistochemical staining showed the Ki-67 reactive tumor cells accounted for about 1% (× 400) (E).
Multi-phase contrast-enhanced CT of peripheral PSP with lower Ki-67 index. Axial unenhanced CT image revealed a peripheral isodense nodule in the right upper lobe with a CT density of 46 Hu (A). After administration of the contrast medium, the lesions showed homogeneous enhancement. The lesion showed progressive and continuous enhancement in the arterial phase (73 Hu) (B) and venous phase (102 Hu) (C), with a certain enhancement washout in the delayed phase (87 Hu) (D). Immunohistochemical staining showed the Ki-67 reactive tumor cells accounted for about 1% (× 400) (E).

Imaging and clinical comparisons between central and peripheral pulmonary sclerosing pneumocytomas (PSPs)

Central PSPs (n = 15)Peripheral PSPs (n = 18)P
Age (years)56.6 ± 8.551.6 ± 7.70.244
Size (cm3)10.39 ± 3.254.65 ± 2.610.013*
Respiratory symptoms
  n, present:absent11:44:140.037*
Unenhanced CT density (Hu)37.57 ± 15.6143.64 ± 13.090.312
Arterial phase CT density (Hu)67.09 ± 16.9969.79 ± 18.670.767
Venous phase CT density (Hu)91.36 ± 20.4397.14 ± 21.380.373
Delayed phase CT density (Hu)98.73 ± 26.5374.71 ± 24.970.044*
Net enhancement value (Hu)61.47 ± 12.1857.11 ± 10.280.205
Peak enhancement value (Hu)98.73 ± 26.5397.14 ± 21.380.828
Enhancement washout value (Hu)3.8 ± 8.1420.78 ± 10.22< 0.001*
TTP (s)100.81 ± 19.0162.67 ± 20.96< 0.001*
Accelerated index0.63 ± 0.170.99 ± 0.25< 0.001*
Ki-67 index
  n, low:high#9:617:10.030*
Overlying vessel sign
  n, present:absent13:28:100.027*
Prominent pulmonary artery sign
  n, present:absent11:45:130.015*
Obstructive inflammation/atelectasis
  n, present:absent4:110:180.033*
Halo sign
  n, present:absent1:147:110.046*
Peak phase
  n, venous phase:delayed phase3:1215:3< 0.001*
DOI: https://doi.org/10.2478/raon-2023-0042 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
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Language: English
Page range: 310 - 316
Submitted on: Apr 28, 2023
Accepted on: Jul 21, 2023
Published on: Sep 4, 2023
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
pulmonary sclerosing pneumocytoma,
location,
multi-phase computed tomography,
Ki-67
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology,
Radiology

© 2023 Yanli Zhang, Chao Ran, Wei Li, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

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