Pulmonary inflammatory pseudotumour

Case contributed by Dr Eric F Greif

Presentation

Intermittent right chest pain associated with shortness of breath.

Patient Data

Age: 33
Gender: Female

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

33 year old Chinese female presented with intermittent right chest pain and shortness of breath for a few months. A right lower lobe nodule was found on chest xray and a PET/CT was performed for further characterization. The nodule was found to be hypermetabolic. 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 lung. On sectioning a mass is identified in the center 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 color.

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
Case created: 20th Nov 2015
Last edited: 17th Feb 2017
System: Chest
Inclusion in quiz mode: Included

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