Unusual intrapulmonary tumor. A rare cause of bronchiectasis

Fibrobronchoscopic evidence of endobronchial hairs in intrapulmonary teratoma with hemoptysis but without trichoptysis

Intrapulmonary teratoma (IPT) is exceedingly rare, hence preoperative diagnose is usually inaccurate. A 21-year-old man was presented with a 5-year history of recurrent hemoptysis and left upper lung mass with heterogeneous opacity on chest x-ray. Diagnostic fibrobronchoscopy detected tuft of brownish hairs in the left upper anterior segmental bronchus, achieving the diagnosis of IPT preoperatively, which was further confirmed by lobectomy. The case report is noteworthy with fibrobronchoscopic finding of endobronchial hairs in a heterogeneous lesion, which underscores the important role of fibrobronchoscopy in the differential diagnoses of chronic cavitary lesions such as IPT without trichoptysis.

Intrapulmonary mature teratoma

Intrapulmonary teratoma is reported in a 22-year-old male. A chest X-ray in a physical examination showed a round shadow in the left hilum of a 22-year-old man who, on admission, reported slight malaise and a decrease in body weight. Computed tomographic scan and magnetic resonance imaging of the chest showed a heterogeneously dense cystic lesion. The preoperative diagnosis was anterior mediastinal teratoma, and the tumor was located in the anterior segment of the left upper lobe after thoracotomy. Segmentectomy of the left upper division showed a 4.0 x 3.5 cm tumor diagnosed as an intrapulmonary mature teratoma--the 27th such case reported in the English-language literature. This is, to the best of our knowledge, the first intrapulmonary teratoma involving magnetic resonance imaging.

Primary pulmonary germ cell tumor with blastomatous differentiation

We describe the clinical and pathologic findings of a patient with mixed blastoma-germ cell malignancy primary in the lung. Serum alpha-fetoprotein levels were elevated at presentation, and normalized with anti-germ cell chemotherapy. The resection specimen contained massively necrotic germ cell tumor with viable mature neural tissue, plus viable biphasic blastoma with stromal bone and skeletal muscle differentiation. It is not clear whether the germ cell component represents unusual differentiation of a somatic cell line or whether the blastoma component represents an unusual pattern of teratomatous differentiation.