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Inflammatory pseudotumor of the lung in a child with mycoplasma pneumonia
1Department of Pathology, Seoul National University, Children's Hospital, Korea.
Abstract:
A case of inflammatory pseudotumor of the lung occurring in a six-year-old boy is reported with clinicopathologic findings, including its ultrastructure. The patient had had frequent upper respiratory tract infections, and one and half year before the discovery of the lung mass, he suffered from pneumonia of the right lung, which was serologically proven to be a mycoplasma pneumoniae infection. Exploratory thoracotomy revealed a large mediastinal mass that was removed together with the right middle and lower lobes of the lung. The mass arose from the lung with an endobronchial element. Microscopically, the mass was composed of a variety of inflammatory and mesenchymal cells, including plasma cells, histiocytes, lymphocytes, and fibroblast-like spindle cells. Ultrastructurally, the spindle-shaped mesenchymal cells were either fibroblasts or myofibroblasts. At the time of diagnosis of the inflammatory pseudotumor of the lung, the serum titer of antimycoplasma antibody rose again, and the lung parenchyma adjacent to the mass showed interstitial pneumonia with features of bronchiolitis obliterans. The present case suggests that the inflammatory pseudotumor of the lung could be a postinflammatory lesion associated with mycoplasma pneumoniae infection.
Insights
This case report details an inflammatory pseudotumor of the lung in a child, potentially linked to Mycoplasma pneumoniae infection. The findings suggest it may be a post-inflammatory response to the bacterial infection.
Area of Science:
- Pediatric Pulmonology
- Pathology
- Infectious Diseases
Background:
- Inflammatory pseudotumors (IPTs) are rare lung lesions.
- Pediatric lung masses require careful differential diagnosis.
- Recurrent respiratory infections can precede lung pathology.
Observation:
- A six-year-old boy presented with a large mediastinal mass and endobronchial component.
- History included recurrent upper respiratory infections and Mycoplasma pneumoniae pneumonia.
- Surgical resection revealed a mass composed of inflammatory and mesenchymal cells.
Findings:
- Histopathology showed a mix of inflammatory cells and fibroblast-like spindle cells (fibroblasts/myofibroblasts).
- Adjacent lung parenchyma exhibited interstitial pneumonia with bronchiolitis obliterans.
- Elevated anti-Mycoplasma pneumoniae antibody titers were noted at diagnosis.
Implications:
- This case suggests a potential link between Mycoplasma pneumoniae infection and pediatric lung inflammatory pseudotumors.
- IPTs may represent a post-inflammatory sequela in children.
- Further research is needed to elucidate the pathogenesis of Mycoplasma-associated lung lesions.