Tracheal Inflammatory Myofibroblastoma: A Rare Tumor of the Trachea

[A case of pediatric tracheal inflammatory myofibroblastic tumor]

Inflammatory myofibroblastic tumor is a rare tumor of mesenchymal origin. A case of intratracheal inflammatory myofibroblastic tumor in a male child was reported. The clinical characteristics, diagnosis, treatment and prognosis of the disease were reviewed based on the literature, and a differential diagnosis between inflammatory myofibroblastic tumor and hamartoma was performed to ultimately confirm the nature of the tumor in the child.

Rare cases of pulmonary inflammatory myofibroblastic tumors in adult male patients: a case report

Pulmonary inflammatory myofibroblastic tumors (IMTs) are rarely reported in adult males. Given the low incidence of IMT and the lack of imaging references and pathological guidance, the misdiagnosis rate of IMT is high. In this article, we describe two cases of IMTs in the lungs. Both patients were adult males with lesions in the right lobe, a history of pulmonary tuberculosis, and a long period of refractory intermittent pulmonary inflammation. Our two male patients both experienced intermittent cough symptoms, but pulmonary IMTs were not suspected for a long time. Both patients were diagnosed with pulmonary tuberculosis before IMT was confirmed and treated with isoniazid (H), rifampin (R), pyrazinamide (Z), and ethambutol (E) (HRZE) or isoniazid (H), levofloxacin (L), pyrazinamide (Z), and ethambutol (E) (HLZE) for months. In Case 2, we observed multiple subpleural cord signs in the left lung, soft tissue mass shadows at the apex of the right upper lobe, a thickened interlobular interval, and scattered patches and nodules in the upper right lung. These features are novel in the identification of IMTs. Both of the pathological findings revealed a great deal of myofibroblasts, fibroblasts and collagen fibers in the lower right lung lesion, accompanied by a large number of plasma cells and foam cell infiltration, which were consistent with the features of IMT. The two patients displayed exceedingly different symptoms, computed tomography (CT) imaging features, and pathological results from those reported in traditional records. These findings provide novel references that will extend understandings of this rare disease.

Hemoptysis secondary to pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation: A case report and literature review

Objectives

Pulmonary vein stenosis (PVS) is a known complication after radiofrequency ablation of atrial fibrillation (RAAF) and is often misdiagnosed owing to lack of awareness regarding PVS among noncardiologists. Misdiagnosis results in unnecessary treatment; therefore, greater understanding of PVS can improve the management of these patients.

Methods

We report the case of a 38-year-old man with a history of RAAF who presented with massive hemoptysis. His symptoms persisted despite undergoing transcatheter bronchial artery embolization on two occasions.

Results

Pulmonary computed tomography angiography revealed a completely occluded left superior pulmonary vein. Considering the patient’s history of RAAF, we diagnosed him with RAAF-induced PVS and performed left superior lobectomy after which hemoptysis did not recur.

Conclusions

Unexplained massive hemoptysis should alert clinicians regarding the possibility of RAAF-induced PVS. Balloon angioplasty and stent placement are used to treat PVS; however, their efficacy is controversial considering the high recurrence rates associated with these interventions.