Lung Image: Inflammatory Myofibroblastic Tumor

Excerpt

A 49-year-old male patient presented to our clinic with cough, fever, and chest pain complaints. With no peculiarities in his personal and family history, his physical examination revealed reduced breathing sounds in the basal regions of his right hemithorax during auscultation. Since opacity was seen at the right lower zone in his posteroanterior chest X-ray, a thoracic tomography was taken that showed a solid mass with irregular boundaries having a pleural base approximately 53 × 42 mm in size localized in the mediobasal segment of the right lower lobe, which had a feeding vessel from the thoracic aorta (Figure 1). In his PET/CT scan, an increased FDG uptake (SUVmax: 10.33) was seen in the mass (Figure 2). Fiberoptic bronchoscopy was normal, and transthoracic fine-needle aspiration biopsy did not allow making a diagnosis. The patient was operated under general anesthesia and right posterolateral thoracotomy incision was performed. The mass, which had a feeding artery from the aorta and could be distinguished from the lung parenchyma with smooth contours, was seen to congest the right lower lobe. After ligaturing the feeding artery, a right lower lobectomy and mediastinal lymph node dissection was performed. The pathological result was reported as inflammatory myofibroblastic tumor (Figure 3). The patient was discharged at postoperative day 4 with no complications, and he was still asymptomatic at the end of a 10-month follow-up period.

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