Primary paraganglioma of the lung: a case report

Abstract

Introduction: Primary paraganglioma of the lung is a rare tumor of which few cases are reported in literature. Both solitary and diffuse primary pulmonary paragangliomas are described. The solitary form of this tumor is rare.

Case presentation: We report the case of a 63-year-old Caucasian man with cough, intermittent palpitations and dyspnea. A contrast-enhanced computed tomography scan of his chest revealed a rounded, high-density lesion with irregular profiles measuring 24mm in diameter in the middle lobe. The lesion was suggestive of malignancy. Fine-needle aspiration cytology was performed. The results of the cytological tests were positive for malignant cells. Surgical resection was the choice of treatment. The results of the biochemical tests and postoperative histological examination allowed a definitive diagnosis: primary pulmonary paraganglioma.

Conclusions: Paragangliomas are identified and characterized with the use of computed tomography and other imaging methods, but for a definitive diagnosis, histopathological evaluation is necessary. We report a rare case of a primary pulmonary paraganglioma that was treated surgically. This case report adds valuable knowledge to the literature on pulmonary paragangliomas.

Fig. 1

Radiological images of the pulmonary nodule. Chest X-ray showing a lesion in the right lung field (a). Contrast-enhanced computed tomography scan of the chest revealing a rounded, high-density lesion with irregular profiles with a diameter of 24mm in the middle lobe (b). Fine-needle aspiration (c)

Fig. 2

Histology of the nodule. The definitive histological examination of the nodular lesion, showed a tumor with an organoid pattern (a). At immunohistochemical staining, the cell population was positive for NSE, chromogranin, synaptophysin, natural killer cell-associated antigens CD56 and CD57, GFAP, and negative for CK, EMA, TTF-1 (b, c, d); the protein s100 has marked the base of the nests’ neoplastic cells (e). CK cytokeratin, EMA epithelial membrane antigen, GFAP glial fibrillary acid protein, NSE neuron-specific enolase, TTF-1 thyroid transcription factor-1