A rare histopathological fi nding after lung resection in a child

Česká verzia

Authors: V. Chrenkova ¹; P. Omaník ¹; L. Plank ²; J. Babala ¹
Authors place of work: Klinika detskej chirurgie, Národný ústav detských chorôb, Bratislava, Slovenská republika ¹; Ústav patologickej anatómie, JLF UK, Martin, Slovenská republika ²
Published in the journal: Klin Onkol 2021; 34(2): 142-146
Category: Case Report
doi: https://doi.org/10.48095/ccko2021142

Summary

Background: The authors present a case of a patient with an extremely rare lung tumor in a child. Case: A 9-year-old girl with a 3-day history of dyspnea and stabbing pain in the xiphoid region, irradiating to the area under the left costal margin, both in rest and in physical activities. She was primarily examined in a regional hospital with bounded homogenous focus of the superior right lung lobe on the X-ray. After initial treatment with antibiotics and persistent finding on X-ray, a CT scan of the chest was performed. It revealed an irregular oval lesion of a non-homogenous structure with a contrast dye in the S3 region merged to pericardium and parietal pleura, which the presence of several micronodules. Based on the negative tumor markers, positive PET-CT scan and a negative etiology, biopsy or eventually a lesion exstirpation were indicated. Right-sided thoracotomy, mass enucleation and exstirpation of nodular lesions were performed 2.5 months after the onset of difficulties. Postoperative recovery was uneventful, no sign of recurrence occurred during a follow-up period. The final histological finding was verified as an inflammatory myofibroblastic tumor – an extremely rare pulmonary pathology in the pediatric population. Conclusion: Inflammatory myofibroblastic tumor can be mimicking IgG4 sclerosing disease and inflammatory pseudotumor. It is essential to distinguish between these affections because of different (i.e. surgical vs. conservative) treatment approach.

Keywords:

inflammatory myofibroblastic tumor – inflammatory pseudotumor – IgG4 – lung tumor

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