E-ISSN 2577-2058
 

Case Report 


Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules

Anugayathri Jawahar, John Hibbeln, Ari Goldberg.

Abstract
Cystic lung lesions have limited differential diagnosis, which includes pulmonary Langerhans cell histiocytosis (LCH), lymphangioleiomyomatosis (LAM), lymphocytic interstitial pneumonitis (LIP), tracheobronchial papillomatosis, and Birt-Hogg-Dube syndrome. However, a few rare entities such as pulmonary placental transmogrification (PPT) and metastatic endometrial stromal cell sarcoma (ESS) also can present as cystic lung lesions and pose diagnostic challenges to both radiologists and pathologists. Clinical history is the key in such situations. Since the first description in the literature of these both entities, there have been very few cases reported. We present our case in a middle-aged female who was known to have cystic lung disease but treated as LAM and had a recurrent pneumothorax. Surgical pathology ruled out LAM and other interstitial cystic lung diseases and provided a diagnosis of PPT on wedge resection. Subsequent recurrence of cystic lung nodules led to the re-examination of histopathology and immunohistochemistry, concluding a diagnosis of metastasis from remote but undiagnosed low-grade stromal cell sarcoma. We will discuss the clinical, imaging and pathologic features of both of the diagnoses in this report. Institutional review board approval was not required since it was a single patient report.

Key words: Placental transmogrification, Endometrial stromal cell sarcoma, stromal metastases, pulmonary cyst, cystic lung nodule.


 
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How to Cite this Article
Pubmed Style

Jawahar A, JH, Goldberg A. Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules. A J Diagn Imaging. 2019; 5(2): 22-28. doi:10.5455/ajdi.20190311030045


Web Style

Jawahar A, JH, Goldberg A. Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules. http://www.jdiagnosticimaging.com/?mno=36324 [Access: December 11, 2019]. doi:10.5455/ajdi.20190311030045


AMA (American Medical Association) Style

Jawahar A, JH, Goldberg A. Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules. A J Diagn Imaging. 2019; 5(2): 22-28. doi:10.5455/ajdi.20190311030045



Vancouver/ICMJE Style

Jawahar A, JH, Goldberg A. Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules. A J Diagn Imaging. (2019), [cited December 11, 2019]; 5(2): 22-28. doi:10.5455/ajdi.20190311030045



Harvard Style

Jawahar, A., , . J. H. & Goldberg, . A. (2019) Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules. A J Diagn Imaging, 5 (2), 22-28. doi:10.5455/ajdi.20190311030045



Turabian Style

Jawahar, Anugayathri, John Hibbeln, and Ari Goldberg. 2019. Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules. American Journal of Diagnostic Imaging , 5 (2), 22-28. doi:10.5455/ajdi.20190311030045



Chicago Style

Jawahar, Anugayathri, John Hibbeln, and Ari Goldberg. "Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules." American Journal of Diagnostic Imaging 5 (2019), 22-28. doi:10.5455/ajdi.20190311030045



MLA (The Modern Language Association) Style

Jawahar, Anugayathri, John Hibbeln, and Ari Goldberg. "Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules." American Journal of Diagnostic Imaging 5.2 (2019), 22-28. Print. doi:10.5455/ajdi.20190311030045



APA (American Psychological Association) Style

Jawahar, A., , . J. H. & Goldberg, . A. (2019) Diagnostic challenge between placental transmogrification and low-grade endometrial stromal sarcoma metastases in a patient with cavitary pulmonary nodules. American Journal of Diagnostic Imaging , 5 (2), 22-28. doi:10.5455/ajdi.20190311030045





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