A Case of Huge Pulmonary Blastoma With Multiorgan Invasion

다기관 침범을 동반한 거대 폐 모세포종

  • Lee, Tae Hwan (Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School) ;
  • Lee, Ka Young (Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School) ;
  • Kim, So Ri (Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School) ;
  • Min, Kyung Hun (Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School) ;
  • Park, Seoung Ju (Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School) ;
  • Lee, Heung Bum (Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School) ;
  • Rhee, Yang Keun (Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School) ;
  • Lee, Yong Chul (Department of Internal Medicine and Airway Remodeling Laboratory, Chonbuk National University Medical School)
  • 이태환 (기도 개형 연구실, 전북대학교 의과대학 내과학교실) ;
  • 이가영 (기도 개형 연구실, 전북대학교 의과대학 내과학교실) ;
  • 김소리 (기도 개형 연구실, 전북대학교 의과대학 내과학교실) ;
  • 민경훈 (기도 개형 연구실, 전북대학교 의과대학 내과학교실) ;
  • 박성주 (기도 개형 연구실, 전북대학교 의과대학 내과학교실) ;
  • 이흥범 (기도 개형 연구실, 전북대학교 의과대학 내과학교실) ;
  • 이양근 (기도 개형 연구실, 전북대학교 의과대학 내과학교실) ;
  • 이용철 (기도 개형 연구실, 전북대학교 의과대학 내과학교실)
  • Received : 2006.11.29
  • Accepted : 2006.12.27
  • Published : 2007.02.28

Abstract

A pulmonary blastoma is a rare malignant tumor of the lung that is composed of epithelial and mesenchymal elements and resembles the structure of an embryonic lung. Pulmonary blastomas have a very poor prognosis and make up 0.25 to 0.5 percent of all primary malignant lung tumors. A pulmonary blastoma usually manifests as a solitary parenchymal mass or nodule and multiple subpleural mass with effusion on chest X-ray and computed tomography. We encountered a very rare case of pulmonary blastoma in a 52 years old male. He complained of abdominal pain, fullness, and dyspnea. The radiology examination revealed a huge lung mass invading the mediastinum, heart, diaphragm, and liver. The percutaneous needle biopsies were performed, and this tumor was diagnosed as a pulmonary blastoma. We report a biopsy confirmed case of a huge pulmonary blastoma invading multiple organs.

폐모세포종은 폐종양으로 매우 드물게 나타나며 드물게 간, 흉외 림프절, 심장으로 전이된다고 보고되고 있다. 본 저자들은 복부의 팽만감과 통증 및 호흡곤란을 주소로 내원한 환자에서 간과 폐의 거대 종괴를 발견하였고, 조직 검사를 통하여 간, 횡격막, 심장 등 다발성 침범을 동반한 폐모세포종으로 진단받은 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Francis D, Jacobsen M. Pulmonary blastoma. Curr Top Pathol 1983;73:265-94
  2. Barnett N, Barnard WG. Some unusual thoracic tumors. Br J Surg 1945;32:447-57 https://doi.org/10.1002/bjs.18003212803
  3. Liman S T, Altinok T, Topcu S, Tastepe AI, Uzarc A, Demircan S,et al. Survival of biphasic pulmonary blastoma. Respir Med 2006;100:1174-9 https://doi.org/10.1016/j.rmed.2005.10.026
  4. GP, Reed CE, Silvestri GA. Pulmonary blastoma: a rare lung malignancy. Lung Cancer 1996 15:233-7 https://doi.org/10.1016/0169-5002(96)00587-9
  5. Di Lieto E, Baldi A, Vicidomini G, Di Marino MP, Baldi F. Pulmonary blastoma in adults. Minerva Chir 1997;52:839-46
  6. Dogan R, Gungen Y, Ucanok K, Cetin G. Pulmonary blastoma. Hacettepe Med J 1989;22:235-9
  7. Koss MN, Hochholzer L, O'Leary T. Pulmonary blastomas. Cancer 1991;67:2368-81 https://doi.org/10.1002/1097-0142(19910501)67:9<2368::AID-CNCR2820670926>3.0.CO;2-G
  8. Jacobsen M, Francis D. Pulmonary blastoma: aclinico-pathological study of eleven cases. Acta Pathol Microbiol Scand 1980;88:151-60
  9. Novotny JE, Hurias CM. Resection and adjuvant chemotherapy of pulmonary blastoma: a case report. Cancer 1995;76:1537-9 https://doi.org/10.1002/1097-0142(19951101)76:9<1537::AID-CNCR2820760906>3.0.CO;2-I
  10. Travis WD, Brambilla E, Muller-Hermelink HK, Harris CC. Small cell carcinoma, and sarcomatoid carcinoma. In: World Health Organization Classification of Tumours. Pathology and genetics of tumours of the lung, pleura, thymus and heart. Lyon: IARC Press 2004. p. 31-34, 53-58
  11. Dienemann D, Hartmann CA, Minck C. Pulmonary blastomas: immunohistochemical investigations of three cases. Pathol Res Pract 1989;184:306-11 https://doi.org/10.1016/S0344-0338(89)80091-3
  12. Adluri RK, Boddu SR, Martin-Ucar A, Duffy JP, Beggs FD, Morgan WE. Pulmonary blastoma: a rare tumor with variable presentation. Eur J Cardiothoracic Surg 2006;29:236-9 https://doi.org/10.1016/j.ejcts.2005.11.035
  13. Zavala-Alarcou E, Sudhakar S, Gonzoles LR, Patel R. Extension of a pulmonary blastoma into the left atrium. Mayo Clin Proc 2001;76:657-60 https://doi.org/10.4065/76.6.657
  14. Lee HJ, Goo JM, Kim KW, Im JG, Kim JH. Pulmonary blastoma:radiologic findings in five patients. Clin Imaging 2004;28:113-8 https://doi.org/10.1016/S0899-7071(03)00240-7
  15. Robert J, Pache JC, Seium Y, de Perrot M, Spiliopoulos A. Pulmonary blastoma: report of five cases and identification of clinical features suggestive of the disease. Eur J Cardiothorac Surg 2002:22:708-11 https://doi.org/10.1016/S1010-7940(02)00529-8