First AD

Second AD

A 58-year-old man, a smoker with recurrent pneumonia, presents with an ill-defined mass in the right lung.

The term transmogrification derives from the word 

 which means, “to change into a different form or shape.” Essentially, this definition tells a great deal of what happens in the lung parenchyma, where the normal tissue is basically replaced by placental villus-like structures.

Since the first description of this particular entity in 1979, originally described as placental transmogrification of the lung, only a few other cases have been described in the literature. Other names that have been coined for this lung abnormality include: placentoid bullous lesion of the lung, giant bullous emphysema, and pulmonary lipomatosis (a variant of placental transmogrification of the lung). It is likely that all those descriptions correspond to the same process.

Clinically this disease has been described in young adults with histories of repeated pneumonia and/or tobacco use. It is very difficult to arrive at this particular diagnosis by clinical and/or radiologic means. Even in small biopsies the disease may not be apparent, requiring complete resection of the lesion in question. Even though placental transmogrification of the lung may involve large segments of the lung parenchyma, complete surgical resection appears to be the treatment of choice. It is deemed to be a benign condition, and up to now no reported cases of recurrence or metastatic disease have been described.

In short, this is a very rare disease that may be close to impossible to diagnose on clinical and/or radiologic grounds, requiring tissue diagnosis and an awareness of this process.

Tumors and Tumor-Like Conditions of the Lung and Pleura

Poll 

A 58-year-old smoker with recurrent pneumonia presents with an ill-defined mass in the right lung. What is your diagnosis?

Lung Mass Found in Patient With Recurrent Pneumonia

Cesar A. Moran, MD