Primary sarcoma of the lung and/or pleural cavity is a rare finding accounting for <0.5% of all thoracic malignancies. Histologically, mesothelioma predominates in this subcategory of neoplasms; its relationship to asbestos exposure and cigarette smoking is well documented. Other tumor types include fibrosarcoma, malignant fibrous histiocytoma, angiosarcoma, leiomyosarcoma, synovial sarcoma, and Ewing sarcoma. Standard evaluation with bronchoscopy and radiographically guided biopsy are frequently nondiagnostic and require open biopsy to provide an adequate tissue sample. Keywords pleural images, pleural malignancy Case StudyA 39-year-old man employed as a housepainter presented with fevers, weight loss, and a nonproductive cough. He reported having a positive tuberculin skin test and received Bacillus Calmette-Guérin vaccine as a youth. Current sputum cultures and cytology were negative for malignancy. Computed tomography of the chest showed a large right pleural effusion and 3 pleural-based nodules (Figure 1). Bronchoscopy demonstrated no endobronchial lesions and a negative aspirate cytology. Thoracentesis and pleural biopsy yielded only pleural fibrosis.Thoracoscopic exploration of the chest revealed a longitudinally spreading, thick, friable tumor mass along the parietal pleural surface of the lung. Light microscopy showed a high-grade spindle cell neoplasm (Figure 2;

No abstract

Brief Reports should be submitted online to www.editorialmanager.com/ amsurg. (See details online under ''Instructions for Authors''.) They should be no more than 4 double-spaced pages with no Abstract or sub-headings, with a maximum of four (4) references. If figures are included, they should be limited to two (2). The cost of printing color figures is the responsibility of the author.