Primary pulmonary paraganglioma

We report a case of primary pulmonary paraganglioma (PPP) in a 19-year-old female. The patient was admitted to the Clinic with high fever, cough, right chest pain, severe fatigue and elevated WBC count. Antibiotic treatment was ineffective. A control chest X-ray showed a 5 x 6-cm tumor formation in the right thoracic cavity which required surgical treatment. Tumorectomy with partial resection of the lobe was performed. The postoperative period was uneventful and the patient was discharged in good general condition, afebrile, with no complaints. Histological and immunohistochemical studies revealed nests of oval cells positive for chromogranin A, surrounded by elongated cells positive for S-100 protein, which was accepted as a definitive trait for PPP. At the control examination six months later the patient was in good general condition and had no complaints. The presented case of PPP (the first ever in the Bulgarian medical literature) is reported because it is exceedingly rare and difficult to diagnose.