IMAGES IN PULMONARY, CRITICAL CARE, SLEEP MEDICINE AND THE SCIENCES Placental Transmogrification of the Lung: A Rare Cause of Unilateral Bullous Disease Michael P. Mohning1, Marvin I. Schwarz1, and Sarah J. McKinley2 1 Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado-Denver, Aurora, Colorado; and 2Colorado Permanente Medical Group, Denver, Colorado
Figure 1. Multiplanar reconstruction of the chest computed tomography demonstrates a large bullous lesion adjacent to a mass in the right lower lobe.
Figure 2. Photomicrograph with hematoxylin and eosin staining shows the tissue with areas resembling placental villi.
A previously healthy 62-year-old male presented for evaluation of progressive dyspnea over a 9-month period associated with a dry, nonproductive cough. He had no prior history of lung disease and was a nonsmoker. Computed tomography of the chest was performed, and revealed a mass adjacent to a large bullous lesion (Figure 1). The patient underwent pneumonectomy, which revealed placental transmogrification of the lung (Figure 2). Placental transmogrification is a rare benign lung malformation leading to unilateral cystic or bullous lesions. These lesions are typically associated with nodules or masses. The tissues grossly and microscopically resemble placental tissue (1–3). The etiology of these lesions is unknown, but it is thought to be due to a benign proliferation of interstitial clear cells (4). It is unknown whether this is a congenital or acquired condition. Resection is typically curative. n Author disclosures are available with the text of this article at www.atsjournals.org.
References 1. Brevetti GR, Clary-Macy C, Jablons DM. Pulmonary placental transmogrification: diagnosis and treatment. J Thorac Cardiovasc Surg 1999;118:966–967. 2. Shapiro M, Vidal C, Lipskar AM, Gil J, Litle VR. Placental transmogrification of the lung presenting as emphysema and a lung mass. Ann Thorac Surg 2009;87:615–616.
3. Vogel-Claussen J, Kulesza P, Macura KJ. Placental transmogrification of the lung. J Thorac Imaging 2005;20: 233–235. 4. Cavazza A, Lantuejoul S, Sartori G, Bigiani N, Maiorana A, Pasquinelli G, Paci M, Rossi G. Placental transmogrification of the lung: clinicopathologic, immunohistochemical and molecular study of two cases, with particular emphasis on the interstitial clear cells. Hum Pathol 2004;35:517–521.
Author Contributions: M.P.M. wrote the manuscript; M.I.S. and S.J.M. contributed to the conceptual framework and edited the manuscript. Am J Respir Crit Care Med Vol 190, Iss 1, p e1, Jul 1, 2014 Copyright © 2014 by the American Thoracic Society DOI: 10.1164/rccm.201307-1361IM Internet address: www.atsjournals.org
Images in Pulmonary, Critical Care, Sleep Medicine and the Sciences
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Figure 1. Multiplanar reconstruction of the chest computed tomography demonstrates a large bullous lesion adjacent to a mass in the right lower lobe.
Figure 2. Photomicrograph with hematoxylin and eosin staining shows the tissue with areas resembling placental villi.
A previously healthy 62-year-old male presented for evaluation of progressive dyspnea over a 9-month period associated with a dry, nonproductive cough. He had no prior history of lung disease and was a nonsmoker. Computed tomography of the chest was performed, and revealed a mass adjacent to a large bullous lesion (Figure 1). The patient underwent pneumonectomy, which revealed placental transmogrification of the lung (Figure 2). Placental transmogrification is a rare benign lung malformation leading to unilateral cystic or bullous lesions. These lesions are typically associated with nodules or masses. The tissues grossly and microscopically resemble placental tissue (1–3). The etiology of these lesions is unknown, but it is thought to be due to a benign proliferation of interstitial clear cells (4). It is unknown whether this is a congenital or acquired condition. Resection is typically curative. n Author disclosures are available with the text of this article at www.atsjournals.org.
References 1. Brevetti GR, Clary-Macy C, Jablons DM. Pulmonary placental transmogrification: diagnosis and treatment. J Thorac Cardiovasc Surg 1999;118:966–967. 2. Shapiro M, Vidal C, Lipskar AM, Gil J, Litle VR. Placental transmogrification of the lung presenting as emphysema and a lung mass. Ann Thorac Surg 2009;87:615–616.
3. Vogel-Claussen J, Kulesza P, Macura KJ. Placental transmogrification of the lung. J Thorac Imaging 2005;20: 233–235. 4. Cavazza A, Lantuejoul S, Sartori G, Bigiani N, Maiorana A, Pasquinelli G, Paci M, Rossi G. Placental transmogrification of the lung: clinicopathologic, immunohistochemical and molecular study of two cases, with particular emphasis on the interstitial clear cells. Hum Pathol 2004;35:517–521.
Author Contributions: M.P.M. wrote the manuscript; M.I.S. and S.J.M. contributed to the conceptual framework and edited the manuscript. Am J Respir Crit Care Med Vol 190, Iss 1, p e1, Jul 1, 2014 Copyright © 2014 by the American Thoracic Society DOI: 10.1164/rccm.201307-1361IM Internet address: www.atsjournals.org
Images in Pulmonary, Critical Care, Sleep Medicine and the Sciences
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