Pulmonary blastoma with diverse mesenchymal proliferation

Abstract

Pulmonary blastomas are extremely rare subpleural tumours consisting of relatively well-differentiated branched tubular glands which resemble fetal lung tissue embedded in a malignant mesodermal stroma. The previous 13 established cases reported up to June 1969 are now supplemented by a fourteenth. The patient was a 32-year-old man who developed acute pain in the right chest followed by a haemorrhagic pleural effusion. At thoracotomy a yellowish-white necrotic and vascular tumour was located lying loosely in the fissure between the upper and the middle lobes. The histological appearance of the tumour was unusual in that the mesodermal element was very variable and in different areas simulated fibrosarcoma, leiomyosarcoma, lipomyxosarcoma, and malignant haemangiopericytoma. This diversity of mesodermal proliferation is best explained on the basis that the tumour has originated in an embryonic or pleuripotential type of mesenchyme, the site of which is probably in the periphery of the lung.