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A child had a pulmonary plasma cell granuloma/fibrous histiocytoma that recurred after lobectomy in 1952 and required pneumonectomy in 1953, at which time it extended into the mediastinum at the pulmonary hilus. A metastatic nodule was removed from within the diaphragmatic musculature. The long-term favorable outcome suggests a good prognosis after adequate surgical therapy. The possible relationship of fibrous histiocytoma/plasma cell granuloma to modified measles is discussed. Cancer 60:1073-1076, 1987. LASMA CELL GRANULOMA of the lung evolving into P a malignant fibrous histiocytoma has been described previously in two cases.'-2 Vascular involvement by pulmonary plasma cell granuloma/histiocytoma also has been reported recently.2 In this childhood case, a recurrent tumor and an intradiaphragmatic metastasis developed with a long-term postoperative survival. Case Report A 7-year-old girl was hospitalized in January 1952 for modified measles, with a temperature of 39.4"C, a sore throat, a cough, and cervical lymphadenopathy. Chest radiography showed a right mid-lung density extending from the medias-tinum almost to the lateral chest wall (Fig. 1). At bronchos-copy, the right upper lobe bronchus was narrowed by extrinsic pressure and was otherwise normal. Subsequent thoracotomy showed a large, very hard pulmonary tumor that was removed by right upper and middle lobectomies. Besides involving most of the excised lung, the tumor had obliterated the right pulmonary artery, superior pulmonary vein and infiltrated the pericardium. Vascular adhesions covered the tumor, which surrounded the vena cava, requiring sharp dissection. There was no evidence of sclerosing mediastinitis. The frozen section and final diagnoses were sarcoma of undetermined type. Consultations with other pathologists in 1952 did not clarify the specific nature of the neoplasm. Stout et al. first identified and reported malignant fibrous histiocytoma as a pathologic entity 1 1 years More than 1 year after surgery, the patient, who had been well, again became ill. Chest radiography demonstrated a large recurrent mass involving the remaining right lower lung lobe. At surgery, the hard nodular tumor also extended into the mediastinum and involved the right pulmonary artery and veins. The residual right lung and tumor were excised, and the veins were ligated at the atrial junction. It was not possible to ascertain that the tumor had been removed entirely. A separate intramuscular diaphragmatic nodule was excised. The lung, mediastinal, and diaphragmatic tumors histopathologi-cally were of the same sarcomatous type as that previously removed. Again, there was no sclerosing mediastinitis. The diaphragm had not previously been touched surgically, and the tumor within its muscle was not an operative implant. The patient recovered satisfactorily but had winter bronchitis. In 1963, progressive thoracolumbar scoliosis required a spinal fusion after 4 years of brace treatment. On admission to nursing school she weighed 90 lbs. In 1973 serious left He

This physician had a craniopharyngioma which was treated by radiation therapy in 1938, with relief of headaches and return to professional activity. Later, penetration of the tumor through the sphenoid sinus into the nasopharynx resulted in the intermittent drainage over 30 years of cystic parts of the tumor into the nasopharynx and from there to the oropharynx without any meningeal rupture. Radiation therapy was the initial mode of treatment, later combined with steroid and thyroid replacement therapy. A professional career was possible in spite of the patient's health problems.