PMC7566176_01
Chest CT. Mediastinal window; a, b, c. A solid heterogeneous 18x19x12 cm
mass can be seen within the 2 lower thirds of the right hemithorax,
causing left shifting of the cardio mediastinum, with compression of the
bronchus towards the right middle and lower lobes, causing atelectasis
of these 2 lobes. The mass has border enhancement, there are mediastinal
adenomegalies of up to 16 mm in the subcarinal station. No pulmonary
infiltrates are seen.
10.1177_1179548420964759-fig1.jpg
PMC7566176_01_10.1177_1179548420964759-fig1.jpg
fig1-1179548420964759
Thoracic X-ray and computed tomography (CT) revealed a large mass with right basal predominance that was encapsulated and non-homogeneous; it occupied 50% to 70% of the right hemithorax (Figures 1 and 2).
Chest CT. Sagittal reconstruction; the mass is seen in the lower right
hemithorax, causing eversion of the right diaphragm.
10.1177_1179548420964759-fig2.jpg
PMC7566176_01_10.1177_1179548420964759-fig2.jpg
fig2-1179548420964759
Thoracic X-ray and computed tomography (CT) revealed a large mass with right basal predominance that was encapsulated and non-homogeneous; it occupied 50% to 70% of the right hemithorax (Figures 1 and 2).
(a) H&E 4X. Histological sections show a mesenchymal lesion that is
arranged in a fascicular and occasionally storiform pattern. The large,
hyalinized and thick walled vessels are very evident. There is no
cytological atypia or signs of mitosis. (b) H&E 10X. At higher
magnification, cells alternate between spindle-cell and round, with
regular contours, without cytological atypia or mitosis.
10.1177_1179548420964759-fig3.jpg
PMC7566176_01_10.1177_1179548420964759-fig3.jpg
fig3-1179548420964759
These results revealed the presence of a malignant fibrous tumor of the pleura and related DPS (Figures 3 and 4).
(a) BCL2 10X. Immunohistochemistry (IHC) shows intense and global
positivity for BCL2 in neoplastic cells. (b) CD34 10X. IHC shows intense
and global positivity for CD34 in neoplastic cells. (c) Ki-67 10X. Ki-67
proliferative index is up to 40% in some areas.
10.1177_1179548420964759-fig4.jpg
PMC7566176_01_10.1177_1179548420964759-fig4.jpg
fig4-1179548420964759
These results revealed the presence of a malignant fibrous tumor of the pleura and related DPS (Figures 3 and 4).
Chest CT. Four years after initial mass resection image shows (a, b, c,
d) a 15x9x10 cm right pleural mass that causes inversion of the right
diaphragm, extrinsic compression of the intermediate bronchus, with
atelectasis of the middle and lower right lobes. Additionally, another
4-cm pleural mass is seen in the upper right anterior area (b, c).
10.1177_1179548420964759-fig5.jpg
PMC7566176_01_10.1177_1179548420964759-fig5.jpg
fig5-1179548420964759
Pulmonary embolism was ruled out, and lung lesions were identified as SFTP recurrence (Figure 5).
PMC7566176_02
(a) H&E 4X. Histological sections show a mesenchymal lesion arranged
in a fascicular and occasionally storiform pattern. Thick and
large-walled vessels are evident. (b) H&E 10X. Histological sections
show a mesenchymal lesion arranged in a fascicular and occasionally
storiform pattern. Neoplastic cells do not have cytological atypia or
mitosis. (c) CD34 10X. IHC shows intense and global positivity for CD34
in neoplastic cells. Vessel walls (except for endothelium) are
CD34-negative. (d) BCL2 10X. IHC shows intense and global positivity for
BCL2 in neoplastic cells.
10.1177_1179548420964759-fig6.jpg
PMC7566176_02_10.1177_1179548420964759-fig6.jpg
fig6-1179548420964759
The Ki-67 was approximately 20% (Figure 6).