Cystic sclerosing haemangioma of the lung

To present three cases of sclerosing haemangioma of the lung (SHL) with prominent cystic changes.

The patients were three women, 27, 35, and 64 years of age. In two cases, the lesion was found on routine chest X-ray and in both instances the diagnosis of SHL was not entertained in the radiological differential diagnosis. In one case, the finding was discovered on post mortem examination. Grossly, the lesions were well-circumscribed and cystic. Histologically, the tumours were characterized by a dual population of small and large bland-appearing neoplastic cells growing in a predominantly cystic pattern. Immunohistochemical staining for epithelial membrane antigen by tumour cells was consistently positive in all three cases. All tumours were negative for keratin, CD34, factor VIII, and S100. The two patients in whom the lesion was identified ante-mortem are alive and free of disease 4 and 7 years after surgical excision.

The present cases indicate that sclerosing haemangioma may present as a cystic pulmonary neoplasm; such a presentation should be taken into consideration when assessing cystic pulmonary lesions.