Pulmonary Placental Transmogrification in a Patient With Suspected Congenital Lobar Emphysema: A Case Report

Pulmonary placental transmogrification (PPT) is a rare benign pulmonary lesion characterized by papillary formations whose stromal architecture closely resembles placental chorionic villi.Of just over 60 cases reported worldwide, none originate from Colombia, and only one has been described in Latin America.We present the case of a 20-year-old male with a prior history of congenital lobar emphysema who presented in February 2024 with acute respiratory distress secondary to progressive bullous disease of the left lung.Chest computed tomography revealed extensive large bullae occupying the entire left lung, prompting a left pneumonectomy.Histopathological examination confirmed PPT, supported by an immunohistochemical panel demonstrating vimentin positivity in the stromal cells, TTF-1 positivity in the lining pneumocytes, and focal CD10 stromal positivity.The postoperative course was complicated by massive hemorrhage necessitating emergency re-thoracotomy, followed by refractory respiratory failure and cardiorespiratory arrest, resulting in the patient's death.This case represents the first report of PPT from Colombia and documents a fatal perioperative outcome not previously described in the PPT literature, highlighting the potentially life-threatening surgical risks associated with pneumonectomy in the setting of extensive bullous disease and underscoring the need for heightened clinical awareness and meticulous perioperative planning.