A Case of Sclerosing Hemangioma Evaluated with Diffusion-Weighted Magnetic Resonance Imaging and 18F-Fluorodeoxyglucose Positron Emission Tomography

A 33-year-old female patient was referred to our hospital for further examination of an abnormal shadow evident on a chest X-ray film. Chest computed tomography (CT) revealed a solid nodule 1.9 cm in diameter in the hilum of the upper lobe of the left lung. Positron emission tomography showed high F-18-fluorodeoxyglucose accumulation in the nodule with a maximal standardized uptake value of 4.5, which favored a malignant lesion. Diffusion-weighted magnetic resonance imaging (DWI), which shows differences in the diffusion of water molecules and can discriminate between malignant and benign lesions, indicated that the nodule had a minimum apparent diffusion coefficient of 1.7 x 10(-3) mm(2)/sec, which was higher than the cutoff value of 1.1 x 10(-3) mm(2)/sec for discriminating between malignant and benign diseases; i.e., values equal to or lower than 1.1 x 10(-3) mm(2)/sec favor malignant disease. The results of a CT-guided needle biopsy of the nodule favored sclerosing hemangioma. During surgery, the tumor did not appear to be invasive, and lymph node metastasis and dissemination were not apparent. On the basis of gross appearance, location, preoperative histological diagnosis, and DWI findings, the tumor was enucleated from the pulmonary parenchyma. Seven months after surgery, the patient was alive and had no evidence of recurrent disease. (Ann Thorac Cardiovasc Surg 2010; 16: 276-280)