2011 Volume 25 Issue 5 Pages 527-532
A 66-year-old woman presented with two nodules in the upper lobe of the left lung on screening computed tomography (CT) scans. These nodules measured 13×8 and 10×5 mm, respectively, and exhibited a homogeneous density and regular margin. Chest CT scans performed 7 years previously demonstrated that these nodules existed in the same sites but were much smaller. We suspected them to be malignant tumors and, thus, performed video-assisted thoracic surgery to resect them. During surgery, the nodules showed cystic lesions filled with clear yellow fluid on the surface of the upper division of the left lung. Pathological findings of the resected specimens revealed no malignant findings in the cyst wall. Immunohistochemistry showed that the lining cells of the cyst were positive for factor- VIII related antigen, CD31, and CD34, and negative for D2-40. These findings suggested that the lining cells originated from the vascular endothelium. However, the tumors were diagnosed as intrapulmonary cystic lymphangiomas on the basis of the morphological and cytological findings. Intrapulmonary cystic lymphangioma is quite rare, and a few cases have been reported. We considered that the present case is atypical of lymphangiomas, and the tumors may have been derived from the premature endothelium which would differentiate into lymphatic vessels.
