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Review
. 2002 Dec;17(4):252-8.
doi: 10.3904/kjim.2002.17.4.252.

Pulmonary inflammatory pseudotumor--a report of 28 cases

Jae Hak Kim  1 , Jae Hee Cho, Moo Suk Park, Jae Ho Chung, Jun Gu Lee, Young Sam Kim, Se Kyu Kim, Sung Kyu Kim, Dong Hwan Shin, Byoung Wook Choi, Kyu Ok Choe, Joon Chang
Affiliations
Review

Pulmonary inflammatory pseudotumor--a report of 28 cases

Jae Hak Kim et al. Korean J Intern Med. 2002 Dec.

Abstract

Background: Pulmonary inflammatory pseudotumor is an uncommon benign lesion of the lung. In Korea, most literature of the pulmonary inflammatory pseudotumor was case reports.

Methods: We collected 28 cases of pulmonary inflammatory pseudotumor in Korea. This collective series included 4 cases from our hospital and 24 cases were reviewed from the literature since 1977. The analysis involved the age, sex, chief complaint, hematologic examination, size and location of the lesion, cavity formation, presence of calcification and treatment method.

Results: Male was more prevalent (81.5%) than female and mean age was 37.9 years old (6-63 yrs). Chief complaints were cough (44.4%), chest pain (29.6%), fever (22.2%), hemoptysis (15%), sputum (15%) and dyspnea (11.1%). There were asymptomatic cases in 11.1%. Hematologic examination revealed normal finding (53.3%) and anemia (20%). The mean size of the lesion was 4.76 cm (1.5-14 cm) and the locations were parenchymal (85.7%), endobronchial (10.7%) and endotracheal (3.6%). Except the endotracheal case, the lesions were in the right (46.4%), the left (42.8%) and bilateral (7.1%). Calcifications (18.5%) and cavitations (11.1%) were present. Diagnostic methods were open thoracotomy (82.1%), bronchoscopy (3.6%), needle aspiration biopsy (7.1%) and core needle gun biopsy (7.1%). Treatments were surgery (85.2%), steroid therapy (7.4%), rigid bronchoscopic removal (3.7%) and observation (3.7%). Postoperative recurrence occurred in only 1 case (4.3%).

Conclusion: Pulmonary inflammatory pseudotumor was more prevalent in the male, and patients presented with the respiratory symptoms were common. It was necessary to do surgery in most cases for diagnosis and/or treatment.

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Figures

Figure 1.
Figure 1.
52-year-old man with pulmonary inflammatory pseudotumor. The chest radiograph showed a huge mass-like density in the left upper and lower lung fields.
Figure 2.
Figure 2.
The chest CT scan showed a huge mass in the posterior segment of left upper lobe and the superior segment of left lobe. It disclosed the multiple cavitary or cystic lesions and air bronchograms.
Figure 3.
Figure 3.
The chest CT scan showed a huge mass in the posterior segment of left upper lobe and the superior segment of left lobe. It disclosed the multiple cavitary or cystic lesions and air bronchograms.
Figure 4.
Figure 4.
Microscopic findings of the biopsy specimen showed dense lymphoplasmacytic infiltration within fibrotic stroma. (H&E stain, ×40)
Figure 5.
Figure 5.
Microscopic findings of the biopsy specimen showed dense lymphoplasmacytic infiltration within fibrotic stroma. (H&E stain, ×200)
Figure 6.
Figure 6.
Twelve months later, the follow-up chest radiograph with the use of prednisolone revealed a marked-size reduction of the mass.
See this image and copyright information in PMC

References

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    1. Kwak YT, Park JC, Yoo SY. Plasma cell granuloma - one case report. Kor J Thorac Cardiovasc Surg. 1981;14:225–227.
    1. Kim SK, Choi KH, Kim KH, Kang MS, Hong PW, Yang WI, Park CI. Fibrous histiocytoma of the trachea. Kor J Med. 1983;26:308–311.
    1. Yoo SH, Kook SP, Suh SK, Kim HM, Choi CS. Inflammatory pseudotumor (histiocytoma) of the left main bronchus. Kor J Med. 1984;27:1520–1523.
    1. Chong DY, Han BS, Jang DC, Lim SP, Hong JS, Lee Y. Plasma cell granuloma of the lung - a report of 2 cases. Kor J Thorac Cardiovasc Surg. 1985;18:487–491.

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