Sclerosing haemangioma with lymph node metastasis

Sclerosing haemangioma (SH) of the lung is an intrapulmonary tumour composed of polygonal and cuboidal cells arranged in a heterogeneous pattern. SH is generally regarded as benign or very low-grade; only rarely have cases of lymph node metastasis been reported. We report a case of SH with metastasis to the regional lymph nodes in an 18-year-old male, whose left lung tumour was identified incidentally on routine CXR. The left upper lobe was removed and the regional lymph nodes dissected. The tumour consisted of proliferative cuboidal and polygonal cells arranged in a papillary pattern within the sclerotic stroma. Subcapsular metastasis was observed in a lymph node. SH with lymph node metastasis was diagnosed. The patient was disease-free at follow up after 2 years. Lobectomy with nodal dissection is suggested for the treatment of pulmonary SH, especially in the case of large tumours with enlargement of regional lymph nodes. Investigation of more cases and long-term follow up are necessary to assess the clinical significance of lymph node metastasis.