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Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance...
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Surgical Treatment of an Endolymphatic Sac Tumor
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Primary lung chordoma: a case report.

Naoko Shigeta1, Tetsuya Isaka2, Kyoko Ono3

  • 1Department of Thoracic Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi, Yokohama, Kanagawa, 241-8515, Japan. e123048c@gmail.com.

Diagnostic Pathology
|July 3, 2024
PubMed
Summary

This study presents a rare case of primary lung chordoma in a patient with a history of testicular germ cell tumors. Differentiating lung chordoma from metastasis requires careful histomorphology and genetic analysis.

Keywords:
BrachyuryFISHIsochromosome 12pLung chordomaTesticular mixed germ-cell tumor

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Area of Science:

  • Oncology
  • Pathology
  • Genetics

Background:

  • Chordoma is a rare malignant tumor originating from notochordal remnants, typically found along the spinal axis.
  • Primary lung chordomas are exceptionally rare, with limited documented cases.
  • This report details a unique case and diagnostic considerations for primary lung chordoma.

Observation:

  • A 39-year-old male with a history of testicular mixed germ cell tumor presented with slow-growing lung lesions.
  • Histological examination revealed physaliphorous cells suggestive of chordoma.
  • Immunohistochemistry confirmed markers including brachyury, S-100, EMA, vimentin, and cytokeratin AE1/AE3.

Findings:

  • Re-evaluation of the testicular tumor showed no notochordal elements, ruling out metastasis.
  • Fluorescence in situ hybridization (FISH) excluded isochromosome 12p and 12p amplification in the lung tumor.
  • A definitive diagnosis of primary lung chordoma was established based on integrated histomorphological and genetic findings.

Implications:

  • Distinguishing primary lung chordoma from metastatic germ cell tumors is critical.
  • Histomorphology (Hematoxylin and Eosin staining) and brachyury staining are essential.
  • FISH analysis for isochromosome 12p and 12p amplification aids in accurate diagnosis of rare lung chordomas, especially in patients with prior testicular tumors.