[Diagnosis and Intraoperative Decision-making in Pulmonary Sclerosing Pneumocytoma with Atypical Imaging Findings: A Case Report and Review of the Literature].

Pulmonary sclerosing pneumocytoma (PSP) is a rare benign pulmonary tumor that predominantly occurs in middle-aged women. Its preoperative diagnosis remains challenging, and it is frequently misdiagnosed as a malignant tumor. Herein, we report a case of PSP with atypical imaging manifestations and review the current literature on this entity. A 68-year-old woman presented with chest tightness. Chest computed tomography (CT) revealed a lobulated solid nodule in the right middle lobe measuring approximately 26 mm × 22 mm, accompanied by multiple enlarged lymph nodes in the bilateral hilar, mediastinal, and axillary regions. The diagnosis of PSP was confirmed by postoperative histopathology. Based on the features of this case and review of the relevant literature, we suggest that when a patient presents with clinical features suggestive of PSP and intraoperative frozen-section hematoxylin and eosin staining predominantly shows a single solid or papillary architecture in which the surface and stromal cells are difficult to distinguish, intraoperative rapid immunohistochemistry may be performed to improve diagnostic accuracy and avoid excessive surgical resection.
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