Home > Cases > Main Index > Case 40 | Lung Index  

SRS-X The SRS Educational Resource

Case 40

Pulmonary blastoma

A young woman with chest pain

Avi Saks

This 39 year old lady presented with a sudden onset of left sided chest pain. W

CT was obtained to clarify the abnormal contour of the left hemidiaphragm. It demonstrates a large mass with a pleural base, immediately above the hemidiaphragm. Ultrasound (not shown) confirmed this to be a solid mass separate from the diaphragm.

Findings

The final film (below) was obtained a few months later and shows rapid enlargement with a secondary pleural effusion. The differential is that of a peripheral lung or pleurally-based malignancy.

Diagnosis was made on pleuroscopy and biopsy, although a CT guided biopsy would be an alternative.

Diagnosis

Pulmonary blastoma

Discussion

Pulmonary blastoma is a rare malignant embryonal neoplasm, presumably arising from primitive pulmonary mesenchyme, analagous to the origin of nephroblastoma (Wilm's tumour). Histologically they resemble foetal lung. They tend to occur peripherally and have a poor prognosis. This patient died nine months after diagnosis despite chemotherapy.

References

Anonymous. Image interpretation session. Pulmonary blastoma. Radiographics 1990; 10: 146-8.
Han SH, Wills JJ, Allen OS. Pulmonary blastoma: a case report and literature review. AJR 1976; 127: 1048-9

Main Index  |   Previous Case

Lung Index  |   Previous Case

Main Index as Unknowns

Lung Index as Unknowns