Some unusual thoracic tumours

Abstract

THIS small group of cases seemed to be worthy of publication partly because they illustrate the expanding scope of thoracic surgery which, as each year passes, brings new problems for solution, and partly because the lesions themselves may properly be described as unusual.Two are examples of pathological lesions which occurred in the pre-pericardial pad of fat. This structure has received but scant recognition from the anatomists, and its existence is not mentioned in the standard text-books. It is, nevertheless, the seat of disease upon occasion, and several interesting papers recently published in American journals have testified to this fact.One case is that of a teratoma of the lung.We are aware of the difficulties of finally assessing the exact nature of many of the pathological processes in this organ, but, in this instance, the definite mixture of carcinomatous and sarcomatous elements leaves but little doubt of the diagnosis.T w o patients suffering from adenoma of the bronchus are included. This condition is now well recognized, but many points pertaining to the clinical features and to the wisest methods of treatment are still sub judice, and it is for this reason that the cases are presented. PREPERICARDIAL CYSTCase I.-Mr.H. M., aged 36, was admitted to St. Thomas's Hospital in March, 1943. He had noticed increasing dyspncea on exertion over a period of six months. By profession he was a shot-blaster, and it had been assumed that the shortness of breath might have been due to his trafe. He also complained of intermittent ' pressure behind the lower end of the sternum, but there was nothing to suggest pain of the anginal type.Physical examination was negative in all respects and the patient appeared to be in excellent health; but radiographs of the chest revealed an opacity, about the size of an orange, situated in the right chest and lying in the angle between the right border of the heart and the dome of the diaphragm (Figs. 380, 381). The mass lay in the extreme front of the chest, immediately behind the sternum.The patient had an occasional cough and some mucoid sputum ; the latter contained neither significant organisms nor malignant cells. The temperature, pulse, and respiratory rates were normal; the blood-pressure was 140/9o mm. of mercury and the Wassermann and Kahn reactions were negative. The bronchial tree was shown to be normal by bronchoscopy and bronchograms, and the diaphragm was not paralysed. The electrocardiograph was normal, and the possibility of a diaphragmatic hernia (through the foramen of the internal mammary

Sarcomatoid Carcinomas of the Lung: A Clinicopathologic Review

“…Since its initial description by Barnett and Barnard 49 and a later discussion by Spencer, 50 pulmonary blastoma (PB) has been regarded by some observers as the pulmonary counterpart of primitive malignant tumors of other organs in childhood. [51][52][53][54][55][56][57] This view has been fostered in part by confusion of PB with pleuropulmonary blastoma (PPB), which is confined to prepubescent and adolescent patients.…”

Pancreatic metastasis of a pleuropulmonary blastoma in an adult

“…Different subtypes can be classified and they vary in their age distribution, peaking in childhood before 10, and at 40 or 70 years of age [2,3]. One subgroup of the sarcomatoid carcinomas family, the pulmonary blastomas, has been regarded as the pulmonary counterpart of primitive malignant tumors of other organs [4,5]. In 1988, the pleuropulmonary blastoma (PPB) found in children was differentiated from the classic adult type pulmonary blastoma by its pathologic features like primitive blastoma and sarcoma without carcinomatous components [6].…”

Dyspnoea and a lung mass in a young female 2 weeks after Caesarean delivery: Figure 1–

“…Age-related factors not only increase the risk of TB reactivation but also enhance susceptibility to TB infection, abetting outbreaks, e.g. in nursing homes [2,3]. To optimise healthcare services and TB control in this subpopulation of growing impact, detailed knowledge of the epidemiological features of TB in the elderly is needed.…”

“…The first description of pulmonary blastoma was published in 1945 by BARRETT and BARNARD [3], when the disease was initially named pulmonary embryoma because of its microscopic resemblance to embryonic lung. Pulmonary blastoma is nowadays subdivided into three categories: classic biphasic pulmonary blastoma; welldifferentiated fetal adenocarcinoma; and pleuropulmonary blastoma [4].…”