Postradiofrequency ablation inflammatory pseudotumor associated with pulmonary venoocclusive disease: case report and review of the literature.
Radiofrequency ablation of pulmonary veins is a common therapeutic intervention for atrial fibrillation. Pulmonary vein stenosis and venoocclusive disease are recognized complications, but the spectrum of pathologies postablation have not been previously reviewed. A recent case at our hospital showed a left hilar soft tissue mass in association with superior pulmonary vein stenosis in a patient 4 years postablation. On resection, this proved to be an inflammatory pseudotumor composed of myofibroblasts in an organizing pneumonia-type pattern with adjacent dendriform ossifications. Pulmonary venoocclusive change was a prominent feature. Literature on the histopathology of postradiofrequency ablation complications is limited. The severity of vascular pathology appears to increase with the postablation interval. Although pulmonary vascular changes are the most common late finding, fibroinflammatory changes including pulmonary pseudotumor formation, attributable to thermal injury, should be considered in the differential diagnosis of these cases.
Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA.
Alexandra E
AE
Kovach
George Z
GZ
Cheng
Colleen L
CL
Channick
Richard N
RN
Channick
Ashok
A
Muniappan
Henning A
HA
Gaissert
Richard L
RL
Kradin
D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy; D017115:Catheter Ablation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D016726:Plasma Cell Granuloma, Pulmonary / Q000150:complications / Q000209:etiology / Q000473:pathology*; D011668:Pulmonary Veno-Occlusive Disease / Q000150:complications / Q000209:etiology / Q000473:pathology*
Inflammatory pseudotumor; Pulmonary vein stenosis; Radiofrequency ablation; Veno-occlusive disease