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Case Reports
. 2013 Jul-Aug;33(4):400-3.
doi: 10.5144/0256-4947.2013.400.

Mimicry of sugar tumor and minute pulmonary meningothelial-like nodule to metastatic lung deposits in a patient with rectal adenocarcinoma

Maria Abdulrahim Arafah  1 , Emad Raddaoui, Abdulmalik Alsheikh, Waseem M Hajjar, Fatimah Alyousef
Affiliations
Case Reports

Mimicry of sugar tumor and minute pulmonary meningothelial-like nodule to metastatic lung deposits in a patient with rectal adenocarcinoma

Maria Abdulrahim Arafah et al. Ann Saudi Med. 2013 Jul-Aug.

Abstract

Several reports have described different lung lesions mimicking primary or metastatic neoplasms. In this paper, we describe the different features of two uncommon and benign lung lesions mimicking metastasis from a primary large bowel adenocarcinoma. Our patient is a 75-year old female with a history of invasive rectal adenocarcinoma. One month after her surgery, she started complaining of coughing and shortness of breath. Clear cell sugar tumor and minute meningothelial-like nodules had been found incidentally and simultaneously during her chest x-ray. The diagnosis had been made based on morphology and was supported by a positive staining to a panel of immunohistochemical stains including CD34, vimentin, HMB45, melan A and S100. An ultra-structural examination was also performed and confirmed the presence of melanosomes in sugar tumor. The coexistence of lung sugar tumor and minute pulmonary meningothelial-like nodules has never been reported in the literature and an awareness of these lesions is essential to correctly diagnose and stage patients.

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Figures

Figure 1
Figure 1
Sugar tumor comprising clear cells with distinct cellular borders and entrapped bronchi (hematoxylin and eosin ×200).
Figure 2A
Figure 2A
Immunohistochemical stains showing cytoplasmic positivity to HMB-45 (2A ×400) and melan A (2B ×400).
Figure 2B
Figure 2B
Immunohistochemical stains showing cytoplasmic positivity to HMB-45 (2A ×400) and melan A (2B ×400).
Figure 3
Figure 3
Cytokeratin cocktail immunohistochemical stain showing the contrast between the negative tumor cells and the entrapped bronchial epithelium.
Figure 4
Figure 4
Perivascular nests of minute pulmonary meningothelial-like nodule (hematoxylin and eosin ×200).
See this image and copyright information in PMC

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