Pulmonary capillary hemangiomatosis diagnosed by pathology of explanted lungs: a unique etiology serves as a key of clinical diagnosis

Gen Thorac Cardiovasc Surg. 2019 Mar;67(3):332-335. doi: 10.1007/s11748-018-0950-x. Epub 2018 May 26.

Abstract

A 27-year-old female patient had presented progressing exertional dyspnea due to pulmonary hypertension. Chest CT revealed diffusely spread patchy ground-glass opacities sparing subpleural parenchymal areas suggesting the diagnosis of pulmonary veno-occlusive disease (PVOD). Despite the diagnosis of PVOD, she was somehow managed by a repetitive escalation of the epoprostenol dose and oxygen supply during the 12-month waiting period until successful bilateral lung transplantation was performed. Pathology demonstrated capillary proliferation in alveolar septae with scarce lesions of narrowed and/or occluded postcapillary small veins, leading to the final diagnosis of pulmonary capillary hemangiomatosis (PCH), not PVOD. We herein present a case of PCH diagnosed after lung transplantation with a focus on its etiology and a key to clinical diagnosis.

Keywords: Lung transplantation; Pulmonary capillary hemangiomatosis; Pulmonary veno-occlusive disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Dyspnea / etiology
  • Female
  • Granuloma, Pyogenic / complications
  • Granuloma, Pyogenic / diagnosis*
  • Granuloma, Pyogenic / pathology
  • Granuloma, Pyogenic / surgery
  • Humans
  • Hypertension, Pulmonary / etiology
  • Lung Diseases / complications
  • Lung Diseases / diagnosis*
  • Lung Diseases / pathology
  • Lung Diseases / surgery
  • Lung Transplantation
  • Tomography, X-Ray Computed