Solitary fibrous tumour (SFT) is a rare neoplasm which most frequently occurs in the pleura, especially visceral pleura, but it is known that intrapulmonary SFT is very rare. We report the case of a 60-year-old woman who was admitted with a 6-year history of slow enhancing intrapulmonary nodular lesion in her right upper lobe on chest computed tomography (CT). A right upper lobectomy was performed for complete excision of the tumour and the postoperative histopathological examination revealed SFT. No pathology was observed during the period of 34-month postoperative follow-up. Herein we present an extremely rare case of intrapulmonary SFT that was located in the deep pulmonary parenchyma.
Müköz bezi adenomu, çoğunlukla trakeobronşiyal seromü-sinöz bezi ve duktusların son derece nadir, benign, egzofitik bir tümörüdür. Bu yazıda, başlangıçta pnömoni olarak değerlendirilen, sol üst lob bronşundan kaynaklanan bir müköz bezi adenomu olgusu literatür incelemesi eşliğinde sunuldu.Anah tar söz cük ler: Benign; bronş adenomu; müköz bezi adenomu.Mucous gland adenoma is an extremely rare, benign, predominantly exophytic tumor of the tracheobronchial seromucinous glands and ducts. In this article, we report a case of mucous gland adenoma arising from the left upper lobe bronchus, which was initially misdiagnosed as pneumonia in the light of literature review.Key words: Benign; bronchial adenoma; mucous gland adenoma. Mucous gland adenoma (MGA) is an extremely rare tumor that arises from the bronchial mucous glands and usually presents as pedunculated or sessile polyps in the lumen of larger bronchi.[1] This type of tumor is truly benign. It can cause obstruction and hemoptysis, but it doesn't extend below the cartilaginous layer of the bronchial wall, and there is no invasive growth or metastasis.[2] We present a case of MGA arising from the left upper bronchus which was successfully treated by surgical resection. CASE REPORTA 52-year-old man was admitted to our hospital with a three-month history of atelectasis and recurrent pneumonitis of the left upper lobe in June of 2008. He had a productive cough but no hemoptysis at the time of admission. His past history was unremarkable. He smoked 72 packs of cigarettes a year until two months prior to his admission. The physical examination was normal. A chest X-ray revealed left upper lobe atelectasis and a hilar density with a fluffy infiltrate adjacent to its periphery (Figure 1a). Chest computed tomography (CT) showed an obstructive lesion in the left upper lobe bronchus (Figure 1b). A bronchoscopic examination revealed a pedunculated papillary lesion obstructing the apicoposterior segment of the left upper lobe bronchus. A biopsy specimen was suggestive of bronchial mucosa and showed severe squamous dysplasia. A left upper lobectomy and mediastinal lymph node dissection was performed via posterolateral thoracotomy in June of 2008. Postoperative pathologic examination identified mucus gland adenoma of the bronchus. The postoperative course was complete and uneventful. Fifteen months after the surgery, there was no sign of tumor relapse, and the patient was asymptomatic.In the pathologic findings, a gross examination of the left upper lobe revealed that the apicoposterior segment bronchus was occluded by a polypoid, wellcircumscribed mass of approximately 1.1 cm in diameter. The tumoral mass projected into the lumen and attached to the bronchial wall with a broad base. The lymph nodes showed reactive inflammatory changes.A microscopic examination revealed a tumor prominent into the bronchial lumen that was covered by regular respiratory epithelial cells. The tumor, composed of glandular structures, was partially surrounded by mucinous epithelium (Figure 2a). Gla...
A 52-year-old male patient with cough and dyspnea was admitted to our clinic. Eight months before admission, he began to feel dyspnea under effort. He had no smoking habit. Respiratory sound was hardly audible in the left lung in the physical examination. No abnormalities were noted in laboratory investigation tests. Forced expiratory volume in one second (FEV1) was 1.20 L. Chest roentgenogram showed a huge mass occupying most of the left hemithorax. Thoracic computed tomography (CT) scan showed a well-circumscribed 30x25x20 cm mass in the left hemithorax ( Figure 1a). Brain CT scan and abdominal CT scan were normal. 18F-fluorodeoxyglucose positron emission tomography (PET) scan showed SUVmax: 4.86 in the mass. Fiberoptic bronchoscopy revealed an extrinsic compression at the left main bronchus, which reduced its lumen by 50%. No endobronchial lesions were observed. Bronchial lavages assessed cytologically showed no malignancy. Fine needle aspiration biopsy samples were obtained, and the results of the biopsy evaluations showed mesenchymal tumor.Left thoracotomy was performed. The thorax was opened at the sixth rib. The tumor was huge (Figure 1b). The lower pulmonary lobe and lingular segment of the upper lobe were atelectatic because of compression of the mass. The tumor originated from the posterior mediastinum and had strong adhesion to both the mediastinal pleura and aorta. Due to the huge size of the mass, it was separated in three pieces, and removed without complications (Figure 1c). The tumor weighed 4300 g and was 31x26x20 cm in size, and was covered with a thin capsule. Histologic examinations revealed leiomyomatous tissue with cellular areas and ischemic necrosis with no cellular anaplasia or mitosis. Immunohistochemical examination was: tumor cells actin +, desmin +, CD34+, S100-, and CD31-. Final pathological diagnosis was leiomyoma from unknown origin. Primary mesenchymal tumors of the mediastinum represent less than 6% of all mediastinal masses (1). Primary mesenchymal tumors of the mediastinum are derived from adipose tissue, blood and lymphatic vessels, fibrous tissue, and muscles (2). Leiomyoma of the mediastinum usually originates in smooth muscle walls (3,4). The majority of leiomyoma cases reported have usually arisen from esophageal muscle. In our case, the tumor was located in the posterior mediastinum and its origin was not clear. This is the largest tumor reported to date, and therefore deserves special attention. 656Manuscript
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