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Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-1723
Ferrante G., D'Armiento F., Griffo S., Gentile M., Costabile R., Cicalese M.
Aim. Pseudotumours of the lung, though most frequent in paediatric age, may also occur in the elderly. The aethiopathogenesis is not clear and even attentive X-ray study, CT scan of the thorax and preoperative cytohistologic examination are unable to point diagnosis to a benign lesion or a primary or metastatic lesion of the lung. We have re-assessed 10 cases of inflammatory pseudotumour of the lung observed between 1985 and 2002 from the clinical, radiological and anatomopathological viewpoints, especially in order to assess the impact of immunohistochemical examinations for diagnostic and follow-up purposes.
Methods. Ten patients with inflammatory pseudotumour of the lung were selected from a group of 16 cases of tumour-like lung lesions. We considered age, gender, symptomatology, imaging, fibrobronchoscopy and preoperative cytohistological examinations. In addition, a panel of immunohistochemical tchniques was prepared so as to better define what type of inflammatory pseudotumour was involved.
Results. This enabled us to better specify the final diagnosis of inflammatory pseudotumour of the lung, studying the different cellular components on the operative preparation: inflammatory, histiocyte, fibroblastic and myofibroblastic and lymphoplasmacellular. For our patients we therefore adopted the following nomenclature: fibrohistiocyte type inflammatory pseudotumour, plasmacellular granauloma type inflammatory pseudotumour, fibrous inflammatory pseudotumour, myofibroblastic pseudotumour, lymphoplasmacellular type pseudotumour, myofibroblastic pseudotumour, lymphoplasmacellular type pseudotumour.
Conclusion. Surgery is indicated for both diagnostic and therapeutic purposes. Immunohistochemical examinations are fundamental for diagnosis. The prognosis for operated patients is good in the short and long terms. Complete removal of the lesion does not lead to recurrences.