Pulmonary inflammatory pseudotumour

Case contributed by Dr Eric F Greif

Presentation

Intermittent right chest pain associated with shortness of breath.

Patient Data

Age: 35 years
Gender: Female
X-ray

Chest radiographs

2 cm oval nodular opacity within the posterior right lower lobe, which is faintly reproducible on lateral radiograph and projects over the anterior lower thoracic vertebra. Remaining lungs are clear.

Nuclear medicine

PET/CT

Hypermetabolic (SUV 13), well circumscribed, lobulated, heterogeneous attenuation, 1.8 cm nodule within the posterior lateral right lower lobe.

 

Status post resection of a right lower lobe nodule. Postoperative changes are present in the region of resection and the adjacent pleura.

Case Discussion

Female presented with intermittent right chest pain and shortness of breath for a few months. A right lower lobe nodule was found on chest x-ray and a PET/CT was performed for further characterization. The nodule was found to be hypermetabolic. The patient was sent for right lower lobe wedge resection for a presumed bronchogenic carcinoma vs. peripheral pulmonary carcinoid tumour.

Pathology results:

Gross Description: Received in formalin designated "Right Lower Lobe" is the product of a wedge biopsy of the lung. On sectioning a mass is identified in the centre parenchyma coming within 0.2 cm from the pleural surface measures 2.2 x 1.2 x 1.0 cm. It is rubbery in consistency and tan white in colour.

Immunohistochemistry staining demonstrates polytypic plasma cells within the lesion; the spindle cells show a smooth muscle phenotype. These findings support the findings of inflammatory pseudotumor, plasma cell granuloma subtype.

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Case information

rID: 41209
Published: 20th Nov 2015
Last edited: 30th Jul 2018
System: Chest
Inclusion in quiz mode: Included

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