Tuberc Respir Dis.  2013 Aug;75(2):71-74.

A Case of Giant, Benign Schwannoma Associated with Total Lung Collapse by Bloody Effusion

• Jang JY
• Kim JS
• Choe JW
• Kim MK
• Jung JW
• Choi JC
• Shin JW
• Park IW
• Choi BW
• Kim JY

Abstract

Benign schwannoma is the most common neurogenic tumor in the mediastinum. Mediastinal benign schwannomas are most often asymptomatic and rarely accompanied by bloody pleural effusion. In the clinical analysis of 7 cases of pulmonary schwannomas, pleural effusion, and blood invasion were evident in 3 patients with malignant schwannoma. Herein, we report a rare case of giant, benign schwannoma presented with total collapse of right lung by massive, bloody pleural effusion.

Keyword

Neurilemmoma; Pleural Effusion

MeSH Terms

Humans
Lung
Mediastinum
Neurilemmoma
Pleural Effusion
Pulmonary Atelectasis

Figure

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  Figure 1 Chest posterior-anterior taken on the day of admission. There is total opacity of the right lung.

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  Figure 2 Pre- and post-contrast chest computed tomography (CT). (A) Pre-contrast chest CT revealed massive pleural fluid collection in the right lung with near total, passive atelectasis. (B) With contrast enhancement, relatively well-circumscribed mass was found in the posterior portion which showed minimal and inhomogeneous enhancement with radio-contrast dye.

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  Figure 3 Video-assisted thoracoscopic view. A dumbbell-shaped, whitish tumor was found in the posterior thorax wall.

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  Figure 4 Pathologic examination. (A) Upon gross evaluation, the mass was a whitish soft tumor measuring 10.0×12.0×3.0 cm with a yellow cut-surface. (B) Upon microscopic exam, the tumor was composed of spindle cells with elongated nuclei, forming interlacing bundle with focal nuclear palisading. Mitotic figures were rare (H&E stain, ×100).

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  Figure 5 Early postoperative and post-discharge chest posterior-anterior images (PAs). (A) A chest PA taken in the afternoon of the operation showed total haziness in the right lung by re-expansion pulmonary edema. (B) A month after the surgery the right lung was fully aerated without infiltration.

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