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Recurrent Spontaneous Pneumothorax Hiding a Rare Pulmonary Tumor in a 4-Year-Old Girl
Recurrent Spontaneous Pneumothorax Hiding a Rare Pulmonary Tumor in a 4-Year-Old Girl Marcello Carlo Ambrogi, MD, PhD, Pietro Bertoglio, MD, Adele Servadio, MD, Vittorio Aprile, MD, Gabriella Fontanini, MD, PhD, and Alfredo Mussi, MD
Fig 1.
Fig 2.
A
four-year-old, white female child was referred to the emergency department for slight chest pain, cough, and a history of low-grade fever in the previous days. Chest radiography showed a hypertensive right pneumothorax associated with complete atelectasis of the lung. A chest tube was positioned with complete resolution of pneumothorax, and the patient was discharged after 5 days. Ten days later, the patient was seen again in the emergency department with cough and dyspnea. Chest radiography revealed a new episode of right hypertensive pneumothorax (Fig 1), and a chest tube was forthwith
Address correspondence to Dr Bertoglio, c/o U.O. Chirurgia Toracica, via paradisa 2, edificio 10, Ospedale Cisanello 56124 Pisa (PI), Italy; e-mail: [email protected].
Ó 2014 by The Society of Thoracic Surgeons Published by Elsevier
Fig 3.
Fig 4.
positioned. A computed tomographic scan was then performed showing a multilocular aerial cyst (Fig 2A) with a caudal solid parenchymatous part (Fig 2B) arising from the lower and middle lobe. After multidisciplinary discussion, the patient underwent surgical intervention performed with a right thoracotomy; two aerial cysts were found arising from the middle and lower lobes. Inside the larger one, whiteyellow, soft parenchymatous areas were found. Frozen section specimen revealed malignant spindle cells. A wide wedge resection of lower and middle lobes was performed (Fig 3). The patient recovered with an uneventful postoperative course. The final diagnosis was type II pleuropulmonary blastoma (Fig 4; hematoxylin and eosin stain, 10), and the patient was referred to the pediatric oncology department. Ann Thorac Surg 2014;98:1847 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2014.07.010
FEATURE ARTICLES
Thoracic Surgery and Pathological Anatomy, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
Fig 1.
Fig 2.
A
four-year-old, white female child was referred to the emergency department for slight chest pain, cough, and a history of low-grade fever in the previous days. Chest radiography showed a hypertensive right pneumothorax associated with complete atelectasis of the lung. A chest tube was positioned with complete resolution of pneumothorax, and the patient was discharged after 5 days. Ten days later, the patient was seen again in the emergency department with cough and dyspnea. Chest radiography revealed a new episode of right hypertensive pneumothorax (Fig 1), and a chest tube was forthwith
Address correspondence to Dr Bertoglio, c/o U.O. Chirurgia Toracica, via paradisa 2, edificio 10, Ospedale Cisanello 56124 Pisa (PI), Italy; e-mail: [email protected].
Ó 2014 by The Society of Thoracic Surgeons Published by Elsevier
Fig 3.
Fig 4.
positioned. A computed tomographic scan was then performed showing a multilocular aerial cyst (Fig 2A) with a caudal solid parenchymatous part (Fig 2B) arising from the lower and middle lobe. After multidisciplinary discussion, the patient underwent surgical intervention performed with a right thoracotomy; two aerial cysts were found arising from the middle and lower lobes. Inside the larger one, whiteyellow, soft parenchymatous areas were found. Frozen section specimen revealed malignant spindle cells. A wide wedge resection of lower and middle lobes was performed (Fig 3). The patient recovered with an uneventful postoperative course. The final diagnosis was type II pleuropulmonary blastoma (Fig 4; hematoxylin and eosin stain, 10), and the patient was referred to the pediatric oncology department. Ann Thorac Surg 2014;98:1847 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2014.07.010
FEATURE ARTICLES
Thoracic Surgery and Pathological Anatomy, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy