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

Yanli Zhang

Yanli Zhang

Department of Clinical Pharmacy, Affiliated Hospital of Yangzhou UniversityYangzhou, China
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Zhang, Yanli
, 
Chao Ran

Chao Ran

Department of Radiology, Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityYantai, China
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Ran, Chao
 and 
Wei Li

Wei Li

Department of Medical Imaging, Affiliated Hospital of Yangzhou UniversityYangzhou, China
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Li, Wei
  
Sep 04, 2023
Central and peripheral pulmonary sclerosing pneumocytomas: multi-phase CT study and comparison with Ki-67's Cover Image
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Article Category: Research Article
Published Online: Sep 04, 2023
Page range: 310 - 316
Received: Apr 28, 2023
Accepted: Jul 21, 2023
DOI: https://doi.org/10.2478/raon-2023-0042
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© 2023 Yanli Zhang et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

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 ± 8.5 51.6 ± 7.7 0.244
Size (cm3) 10.39 ± 3.25 4.65 ± 2.61 0.013*
Respiratory symptoms
  n, present:absent 11:4 4:14 0.037*
Unenhanced CT density (Hu) 37.57 ± 15.61 43.64 ± 13.09 0.312
Arterial phase CT density (Hu) 67.09 ± 16.99 69.79 ± 18.67 0.767
Venous phase CT density (Hu) 91.36 ± 20.43 97.14 ± 21.38 0.373
Delayed phase CT density (Hu) 98.73 ± 26.53 74.71 ± 24.97 0.044*
Net enhancement value (Hu) 61.47 ± 12.18 57.11 ± 10.28 0.205
Peak enhancement value (Hu) 98.73 ± 26.53 97.14 ± 21.38 0.828
Enhancement washout value (Hu) 3.8 ± 8.14 20.78 ± 10.22 < 0.001*
TTP (s) 100.81 ± 19.01 62.67 ± 20.96 < 0.001*
Accelerated index 0.63 ± 0.17 0.99 ± 0.25 < 0.001*
Ki-67 index
  n, low:high# 9:6 17:1 0.030*
Overlying vessel sign
  n, present:absent 13:2 8:10 0.027*
Prominent pulmonary artery sign
  n, present:absent 11:4 5:13 0.015*
Obstructive inflammation/atelectasis
  n, present:absent 4:11 0:18 0.033*
Halo sign
  n, present:absent 1:14 7:11 0.046*
Peak phase
  n, venous phase:delayed phase 3:12 15:3 < 0.001*
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Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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