Diagnosis of multiple pulmonary cavernous hemangiomas via dual-layer spectral CT A case report

Rationale: Cavernous hemangioma is a benign vascular tumor, which very rarely occurs in the lung. When appearing as multiple nodules on chest CT, this tumor can be misdiagnosed as metastatic malignancy. Patient concerns: A 72-year-old woman presented with incidentally found multiple lung nodules on chest radiograph. Diagnoses: Based on information derived from dual-layer spectral CT images, the possibility of slow flow vascular tumor such as cavernous hemangioma was suggested. A pathologic diagnosis of pulmonary cavernous hemangioma was made via video-assisted thoracoscopic biopsy. Interventions: After tissue confirmation, the patient was discharged without further intervention. Outcomes: The patient recovered without any event. Follow-up chest CT performed 6 months later showed no significant interval change in nodule size and distribution. Lessons: Material decomposition images obtained from dual energy CT can help physicians understand the character of tumor vascularity for an accurate diagnosis of pulmonary cavernous hemangioma.