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Case reports

Placental transmogrification of the lung presenting as giant bullae with soft-fatty components

^a Pulmonary Division and PSM-HC/PS-HU, University of Sao Paulo Medical School, Brazil
^b Pathology Division, University of Sao Paulo Medical School, Brazil
^c Pulmonary Division, University of Sao Paulo Medical School, Brazil
^d Thoracic Surgery Division, University of Sao Paulo Medical School, Brazil

Received 11 August 2007; received in revised form 28 September 2007; accepted 4 October 2007.

^_* Corresponding author. Address: Av Dr Eneas de Carvalho Aguiar, 255, sala 7079, Bairro Cerqueira Cesar, CEP 05403-900, São Paulo, SP, Brazil. Tel.: +55 11 30832310; fax: +55 11 30645374. (Email: alfredonicodemos{at}hotmail.com).

A 44-year-old man presented with progressive dyspnea and a previous pneumothorax. Chest CT scan showed a mediastinal shift due to giant bullae containing soft tissue and fatty components in the left lower lung lobe, and a right upper lung lobe partially collapsed. The pulmonary function tests revealed forced vital capacity (FVC) 53% (of the predicted) and forced vital capacity in 1 s (FEV1) 52%. Then, resection of the lower lobe was performed with intention to prevent other pneumothoraxes and to revert the upper lobe collapse. The pathological examination showed a placental transmogrification of the lung (PTL). One month after the surgery, the patient was asymptomatic, the pulmonary function tests normalized and the upper lobe was well expanded. In conclusion, we described the first CT finding of soft tissue and fatty components within the PTL-related bullae, and the PTL should be considered in the differential diagnosis of pulmonary lesions with soft-fatty and air components.

Key Words: Bullae • Lung volume reduction • Lung pathology • Pneumothorax • Pulmonary function

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