Tuberc Respir Dis.  2007 Feb;62(2):149-153. 10.4046/trd.2007.62.2.149.

A Case of Huge Pulmonary Blastoma With Multiorgan Invasion

• Lee TH
• Lee KY
• Kim SR
• Min KH
• Park SJ
• Lee HB
• Rhee YK
• Lee YC

• KMID: 2114604
• DOI: http://doi.org/10.4046/trd.2007.62.2.149

Abstract

A pulmonary blastoma is a rare malignant tumor of the lung that is composed of epithelial and mesenchymal elements and resembles the structure of an embryonic lung. Pulmonary blastomas have a very poor prognosis and make up 0.25 to 0.5 percent of all primary malignant lung tumors. A pulmonary blastoma usually manifests as a solitary parenchymal mass or nodule and multiple subpleural mass with effusion on chest X-ray and computed tomography. We encountered a very rare case of pulmonary blastoma in a 52 years old male. He complained of abdominal pain, fullness, and dyspnea. The radiology examination revealed a huge lung mass invading the mediastinum, heart, diaphragm, and liver. The percutaneous needle biopsies were performed, and this tumor was diagnosed as a pulmonary blastoma. We report a biopsy confirmed case of a huge pulmonary blastoma invading multiple organs.

Keyword

Pulmonary blastoma; Lung cancer; Metastasis

MeSH Terms

Abdominal Pain
Biopsy
Biopsy, Needle
Diaphragm
Dyspnea
Heart
Humans
Liver
Lung
Lung Neoplasms
Male
Mediastinum
Middle Aged
Neoplasm Metastasis
Prognosis
Pulmonary Blastoma*
Thorax

Figure

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  Figure 1 Chest radiographs show a huge mass on right lower lung field. (A) Posteroanterior view, (B) Lateral view of left side

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  Figure 2 A CT scan shows a huge mass (14 × 12 × 11 cm) in the right lower lobe invading diaphragm and liver. (A) Enhanced axial view of CT scan (B) Coronal view of CT scan

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  Figure 3 PET-CT scan shows unevenly hypermetabolic (p-SUV=8.34) huge mass in the right lower lobe invading mediastinum, diaphragm, and liver.

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  Figure 4 Photomicrograph of tissues obtained from percutaneous liver biopsy shows characteristic features of malignant stromal structure composed with undifferenciated small round cells and loose spindle cells. H&E stain (× 100).

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  Figure 5 Immunohistochemical stain for vimentin and CD99 of tissues obtained from percutaneous liver biopsy shows positive reaction in tumor cells (× 100).

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  Figure 6 Photomicrograph of tissues obtained from percutaneous transthoracic needle biopsy shows a malignant stromal structure composed with undifferenciated and immature celluar component. (A) H&E stain (× 100), (B) H&E stain (× 200).

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