PMC4986194_01
Contrast enhanced axial CT scan of the patient before a, b and after c, d surgery. There is a large solid mass in lower zone of right hemithorax with complete collapse of right lower lobe and cardiac displacement to left a. There is also an 18 x 15 mm parenchymal nodule in left upper lobe. Several other smaller nodules are found in this exam (not shown) in the rest of left lung. Two years after resection of the large mass in basal aspect of right hemithorax, there are numerous bilateral parenchymal and pleural-based nodules and masses with maximum size of 42 x 40 mm c, d
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Fig1
Chest CT scan showed 2 huge masses located in right hemi-thorax and multiple smaller masses located in the left hemi-thorax (Fig. 1a, b). Imaging study revealed multiple bilateral parenchymal and pleural-based nodules (Fig. 1c, d).
a: A biphasic tumor which composed of a mixture of malignant epithelial and stromal component (h&e. magnification x 40). b: The epithelial component was consisted of tubular and glandular structures, formed by columnar and cuboidal cells (h&e. magnification x 100). c: The stroma in some foci differentiated to cartilage (h&e. magnification x 40). d: The stroma of tumor was consisted of loose undifferentiated mesenchyme and areas with blastomatous appearance (h&e. magnification x 400)
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Fig2
Permanent pathology report revealed a pulmonary blastoma (Figs. 2, 3).
a-b: CK (AE1/AE3), and TTF-1 are positive in epithelial component. c-e: Vimentin, CD34 and bcl-2 are positive in mesenchymal component. f: beta-catenin is expressed diffusely in both epithelial and mesenchymal elements
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Fig3
Permanent pathology report revealed a pulmonary blastoma (Figs. 2, 3).