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Case for diagnosis: 4-month-old infant with increasing cough, hemoptysis, and anemia
D Snijders1, C Stenghele, C Monciotti
1Department of Pediatrics, Medical Hospital, University of Padua, Padua, Italy.
Insights
A rare case of juvenile xanthogranuloma (JXG) in an infant lung presented with cough and hemoptysis. Histology confirmed JXG, a non-cancerous inflammatory condition, in the infant
Area of Science:
- Pediatric Pulmonology
- Dermatopathology
- Pediatric Oncology
Background:
- Juvenile xanthogranuloma (JXG) is a rare, non-Langerhans cell histiocytosis typically affecting infants and young children.
- Pulmonary involvement is exceptionally rare, presenting diagnostic challenges.
Observation:
- A 4-month-old infant presented with non-productive cough, fever, hemoptysis, and anemia.
- Thoracic HRCT revealed a large, well-defined, vascularized mass in the right lung with central hypodensities.
- Fiberoptic bronchoscopy and bronchoalveolar lavage (BAL) were unremarkable.
Findings:
- Histopathological examination of the resected lung mass was crucial for diagnosis.
- The mass demonstrated inflammatory cells, fibroblasts, and rare Touton giant cells.
- These findings were consistent with a diagnosis of juvenile xanthogranuloma (JXG) of the lung.
Implications:
- This case highlights JXG as a rare differential diagnosis for pediatric lung masses presenting with respiratory symptoms.
- Accurate diagnosis through histology is essential for appropriate management of pediatric pulmonary lesions.
- Further research into the pathogenesis and optimal treatment of rare pulmonary JXG is warranted.
Abstract:
A 4-month-old caucasian infant presented non-productive cough, fever associated with hemoptysis, and increasing anemia. He had mild tachypnoea; routine lab tests were normal. The thoracic HRCT scan showed a very large mass in the right lung adherent to the thorax wall, well defined and limiting the medium and upper lobe; the mass was well vascularized, and with central hypodensic areas. Fiberoptic bronchoscopy and bronchoalveolar lavage (BAL) cytology were normal. The definitive histology of the mass showed the presence of inflammatory cells admixed with fibroblasts and rare Touton giant cells in the lesion suggestive of a juvenile xanthogranuloma (JXG) of the lung.
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