Upper Lobe Of Lung Research Articles

Neurosarcoidosis: a case review

Neurosarcoidosis refers to sarcoidosis involving the central nervous system. Approximately 5–10% of people with systemic sarcoidosis develop central nervous system involvement and half of these present with neurological disease at the time of their initial sarcoidosis diagnosis. We report a case of neurosarcoid in a 55-year-old lady of angloceltic origin who presented with 3 months history of memory disturbances and 2 days of confusion with no history of trauma, fever or vomiting. On examination she was confused but otherwise was normal. The CT of brain showed hydrocephalus with increased intracranial pressure consistent with outflow obstruction. She was treated with bilateral EVD drainage with partial improvement of symptoms. A follow up MRI show ependymal and dural enhancement. Repeated CSF studies showed high protein levels and normal glucose, the cultures were negative. Stereotactic biopsies of choroid plexus and septum pellucidum showed multiple non-necrotising granulomas. Special stains were negative for organisms. PCR for mycobacteria tuberculosis and avium complex was negative. Subsequent CT chest showed several small benign-appearing right upper lobe lung nodules. A preferred diagnosis of sarcoidosis was made with brain and meningeal and possible lung involvement.

Clinical Characteristics and Predictors of Mortality in Patients with Combined Pulmonary Fibrosis and Emphysema Syndrome and Lung Cancer

Rationale: We performed this retrospective study to clarify the clinical characteristics, survival and mortality predictors in patients with combined pulmonary fibrosis and emphysema (CPFE) and lung cancer. Methods: We retrospectively reviewed the medical records of a total of 123 patients with lung cancer, as confirmed according to histological or cytological examinations. Based on the findings of chest CT, the patients were categorized into four groups: LC+normal (n=70); LC+emphysema (n=26); LC+fibrosis (n=10); LC+CPFE (n=17). The clinical characteristics and survival of the LC+CPFE group were compared with those of the other groups. In addition, mortality predictors were evaluated in the LC+CPFE group. Results: The proportion of females was significantly higher in the LC+normal group than in the LC+CPFE and LC+emphysema groups. Significantly more patients were diagnosed with squamous cell carcinoma in the LC+CPFE group than in the LC+normal group. The proportion of patients whose primary mass was located in “nonsubpleural” areas was significantly higher in patients with CPFE who also had lung cancer in the upper lobe than in those with CPFE who also had lung cancer in the other sites. There were significant differences in survival between the LC+normal group and the other groups, whereas there were no significant differences in survival among the LC+emphysema, LC+fibrosis and LC+CPFE groups. In the LC+CPFE group, the patients with a high level of serum KL-6 at diagnosis and upper lobe lung cancer demonstrated a high risk of death. A high level of serum KL-6 at diagnosis was also independently associated with a high risk of death. Conclusions: Patients with CPFE and lung cancer may have distinct clinical characteristics. Strict follow-up is required in patients with CPFE and lung cancer whose serum KL-6 level at diagnosis is higher than the normal range and/or the primary mass of lung cancer is located in the upper lobe.

Free-Floating Thrombi in the Right Atrium Causing Pulmonary Embolism

A 74-year-old man presented to our Emergency Department with acute dyspnoea. His electrocardiogram showed atrial flutter with 2:1 block and a rate of 150 bpm. Initial investigations revealed a D-dimer level of 6.01 mg/dl. Based on the patient’s complaints and the high D-dimer level, computed tomography pulmonary angiography was immediately performed. This showed no evidence of pulmonary embolism, but there were pneumatic changes in the right upper lung lobe. Antibiotics treatment was started with pipracillin/tazobactam, after which the patient’s condition improved. However, on the third day after admission he developed acute dyspnoea, diaphoresis and cardiopulmonary instability immediately after defecation. To promptly confirm our clinical suspicion of pulmonary embolism, a transthoracic echocardiography was carried out. This demonstrated a worm-like, mobile mass in the right heart. The right ventricle was enlarged, and paradoxical septal motion was present, indicating right ventricular pressure overload. The systolic tricuspid valvular gradient was 56 mmHg. The patient was treated with thrombolysis. His condition was greatly clinically improved after 3 hours. After 10 days of hospitalization, the patient was discharged.

Allergic Bronchopulmonary Aspergillosis: A Diagnostic Challenge

Allergic bronchopulmonary aspergillosis (ABPA) is an immunologic condition that results from an allergic immune response to Aspergillus fumigatus, most often occurring in a patient with bronchial asthma or cystic fibrosis. ABPA is diagnosed by constellation of clinical, laboratory, and radiographic criteria. In the absence of typical presentation, ABPA can be misdiagnosed. Our patient presented with a 3 cm right lower lobe lung mass and sub-centimeter right upper lobe lung nodules. The clinical features led to a presumptive diagnosis of lung carcinoma. The patient underwent preoperative bronchial washing and endobronchial biopsy. The washing sample showed large amount of thick mucus containing abundant eosinophils, Charcoat-Leyden crystals, and degenerated cellular debris consistent with “allergic mucin”. These findings were initially overlooked and considered non-specific. Repeat sampling (needle biopsy) showed marked reactive pneumocyte hyperplasia in the background of inflammation, which was misdiagnosed as adenocarcinoma with lepidic growth pattern. The correct diagnosis was made only after the surgical resection of the lesion. Diagnosis of ABPA can be missed due to general unfamiliarity with this entity and its clinical presentation similar to the lung tumor. Accurate diagnosis can be derived from the bronchial washing if the features of “allergic mucin” are recognized and confirmed with microbiological examination.

Acrometastasis from an epidermal-growth-factor-receptor (EGFR) mutation-positive lung adenocarcinoma

We report the first case of epidermal-growth-factor-receptor (EGFR) mutation-positive lung adenocarcinoma with acrometastasis in a 51-year-old woman who presented with a swelling on her right hand. Magnetic resonance imaging revealed an expansile lesion at the base of the 5th metacarpal bone of her right hand with cortical erosion and patchy enhancement suggestive of a malignant transformation of a giant-cell tumor. A core needle biopsy of this lesion showed a metastatic adenocarcinoma on histopathological examination which was immunoreactive to cytokeratin (CK) 7 and thyroid transcription factor (TTF)-1 but not to CK20 suggesting a lung primary. A chest radiograph and computed tomography (CT) scan revealed a right upper lobe lung mass. Fluoro-deoxyglucose hypermetabolism was noted in the lung mass and the right 5th metacarpal bone lesion but not elsewhere on positron-emission-tomography/CT scan. Needle biopsy of the lung mass showed adenocarcinoma with histopathological and immunohistochemical features similar to that of the right 5th metacarpal bone lesion. Both the primary lung adenocarcinoma and the acrometastatic lesion were tested positive for EGFR mutation in exon 21 (L858R substitution). She underwent R0 resection of her right upper and middle lobes with systematic mediastinal lymph nodes resection and wide excision of the metacarpal metastasis followed by cytotoxic chemotherapy. A curative approach with complete resection of the primary tumor and oligometastastic site in Stage IV non-small cell lung carcinoma (NSCLC) followed by additive cytotoxic chemotherapy has not been reported to date and as such there is still no data on disease-free survival with this approach.

An Uncommon Presentation of Tuberculosis with Cervical Pott's Disease Initially Suspected as Metastatic Lung Cancer

Cervical Pott's disease is a rare clinical condition whose diagnosis is usually delayed. We report a case of lung tuberculosis (TB) and cervical Pott's disease mimicking a metastatic lung cancer. The patient presented with persistent cervical pain. Radiologic examinations showed the presence of a lytic lesion of C3 vertebral body, associated with spinal cord compression. A CT scan of the thorax showed a lung nodule highly suspicious for malignancy in the apical region of right lung upper lobe. Neurosurgical decompression was performed. Unexpectedly, histological analysis showed the presence of an inflammatory infiltrate suggestive for TB infection. The patient was immediately treated with antituberculous drugs. Atypical forms of spinal TB, such as cervical TB, can be misdiagnosed as primary or metastatic cancers and lead to delay of treatment initiation that could be fatal. Awareness of this uncommon TB presentation is important to prevent morbidity and mortality associated with spinal cord injury and disease dissemination.

Gynaecomastia, galactorrhoea, and lung cancer in a man

In September, 2012, a 60-year-old man presented with right shoulder pain, productive cough, and dyspnoea of 3 months' duration, with 5 kg weight loss and anorexia. He was a manual labourer and had no history of chest pain, fever, or haemoptysis. He had smoked 20 bidis (thin hand-rolled cigarette-like tobacco wrapped in dried tendu leaf) per day for the past 40 years. He reported no other substance misuse or supplements intake. On examination, we noted no clubbing or lymphadenopathy. Testicular examination was normal. Bilateral gynaecomastia (see appendix) with watery discharge from nipple on squeezing was seen (see video). Radiography (figure A) and CT of the chest showed a mass lesion 9·9×9·4 cm in the right upper lung lobe, with loss of fat planes in the aortic arch and chest wall, multiple nodules in both lower lobes, and enlarged lymph nodes. Fibreoptic bronchoscopy showed a growth in right upper lobe bronchus. Endobronchial biopsy showed squamous cell carcinoma (see appendix). Immunohistochemistry for β-HCG (figure B) was positive, and negative for oestrogen and testosterone. Serum β-HCG was 20 000 IU/L (normal <5 IU/L). Serum 17-β oestradiol was 1160 pmol/L (normal 45–609 pmol/L). A urine pregnancy card test was positive. Liver and renal function tests, and serum concentrations of prolactin, testosterone, luteinising hormone, follicle stimulating hormone, thyroid stimulating hormone, and cortisol, were normal. Visual acuity, visual fields, and fundus examination were normal.

Smart Spotting of Pulmonary TB Cavities Using CT Images

One third of the world's population is thought to have been infected with mycobacterium tuberculosis (TB) with new infection occurring at a rate of about one per second. TB typically attacks the lungs. Indication of cavities in upper lobes of lungs shows the high infection. Traditionally, it has been detected manually by physicians. But the automatic technique proposed in this paper focuses on accurate detection of disease by computed tomography (CT) using computer-aided detection (CAD) system. The various steps of the detection process include the following: (i) image preprocessing, which is done by techniques such as resizing, masking, and Gaussian smoothening, (ii) image egmentation that is implemented by using mean-shift model and gradient vector flow (GVF) model, (iii) feature extraction that can be achieved by Gradient inverse coefficient of variation and circularity measure, and (iv) classification using Bayesian classifier. Experimental results show that its perfection of detecting cavities is very accurate in low false positive rate (FPR).

Recurrent Lobar Torsion

We report a first case of 180° left upper lobe lung torsion followed by a 90° lobar torsion in the same lobe after a left lower lobectomy.

Post-traumatic lung pseudocysts: two case reports in ICU patients.

The traumatic lung pseudocyst is a rare complication of closed thoracic injury. We present two cases with traumatic lung pseudocyst who were admitted in our ICU. CASE 1: A 19 year old man was admitted in the ICU after a motorcycle accident. Chest CT revealed two well defined densities in the right upper lung lobe with presence of air bubbles within them. Four days after admission chest CT showed two cavitary lesions in the upper lobe. The patient showed gradual clinical improvement. Repeated chest CT after 6 months was normal. CASE 2: A 41 year old man was involved in a car-bicycle accident. The patient was admitted in the ICU with respiratory failure and flail chest. Chest CT revealed multiple bilateral rib fractures, right pneumothorax and contusions of the right lung. Two days after admission chest CT showed formation of lung pseudocyst. The patient was gradually stabilised and 22 days after the accident the chest CT revealed resolution of the pseudocysts. The traumatic lung pseudocyst is a rare complication of blunt thoracic trauma. The clinical course of traumatic lung pseudocyst is usually benign, unless complications such as pneumothorax or infection of the cavitary lesion arise. These lesions are more common in children and young adults.

A Case of Synchronous Lung Adenocarcinoma and Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue Type

Abstract SESSION TYPE: Cancer Global Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Extranodal marginal zone B-cell lymphoma (extranodal MZL) of mucosa-associated lymphoid tissue (MALT) type, also called MALT lymphoma, is a distinct subgroup of non-Hodgkin's lymphoma (NHL). More than two thirds of primary pulmonary NHLs are extranodal MZLs but they account for less than 0.5% of all primary lung neoplasms. Only a few cases of simultaneous lung cancer and pulmonary extranodal MZL have been reported. Also, it is extremely rare that primary extranodal MZL occurs in the large airways. To our knowledge, only one case of lung cancer coexisting with extranodal MZL of the large airway has been reported. We report a case of synchronous lung adenocarcinoma and primary extranodal MZL of the left main bronchus.CASE PRESENTATION: A 60-year old woman was referred to our hospital with a pulmonary nodule in the right upper lung seen on chest radiograph during a routine health checkup. She had never smoked. A chest radiograph showed a nodule in the right upper lung. A chest computed tomographic (CT) scan showed a peripherally located 2.4 × 1.8 cm sized solid nodule in the anterior segment of the right upper lobe. Fluorine 18-labeled fluorodeoxyglucose (FDG)-positron emission tomography (PET)-CT scan revealed abnormal FDG uptake in the right upper lobe lung nodule and in the right hilar lymph node. She underwent CT image-guided percutaneous core needle biopsy of the nodule in the right upper lobe. Additionally, a flexible bronchoscopic examination was performed to identify the endobronchial lesion. At bronchoscopy, a few small variable-sized protrusions were observed in the proximal left main bronchus and a biopsy was performed . The needle biopsy specimens of the right lung nodule showed non-mucinous adenocarcinoma. Immunohistochemical stains were positive for CK7 and TTF-1, and negative for CK20. Histopathology of the bronchoscopic biopsy specimens of the left main bronchus lesions showed diffuse proliferation of atypical lymphoid cells beneath the mucosal epithelium. Immunohistochemical stains showed diffuse strong positive for CD20, and were negative for CKpan and CD10. The bronchial lesion was diagnosed as extranodal marginal zone B-cell lymphoma of MALT type. She underwent right upper lobectomy and lymph node dissection for the lung adenocarcinoma. However, she did not receive specialized therapy for extranodal MZL of the left main bronchus. Since then she has been observed regularly.DISCUSSION: Synchronous primary malignancy and extranodal MZL in the same anatomical sites, such as stomach and lung is very unusual. To our knowledge, there is only one other report showing the coexistence of lung cancer and pulmonary extranodal MZL of the large airway. However, in that case, the histology of lung cancer was squamous cell carcinoma. The present case is the first report of the simultaneous occurrence of lung adenocarcinoma and pulmonary extranodal MZL of the large airway. The cause of the synchronous lesions in our case is uncertain. We postulate that a pulmonary extranodal MZL may coincide with a lung adenocarcinoma by accident. Little is known about the mechanism of the simultaneous occurrence of these different tumors. Moreover, the two different malignancies were located in different lungs in this case. However, other possible causes may include common etiologic factors and genetic or epigenetic alterations participating in the development of both the lung adenocarcinoma and extranodal MZL. Further studies will be required to clarify the relationship between lung adenocarcinoma and pulmonary extranodal MZL. It is necessary to accumulate more cases with both malignancies.CONCLUSIONS: In conclusion, we report a unique case of pulmonary extranodal MZL of main bronchus coexisting with lung adenocarcinoma. The patient was asymptomatic and was diagnosed with pulmonary extranodal MZL by chance during investigation of an endobronchial lesion.1) Jaffe ES, Harris NL, Stein H, Vardiman JW. World Health Organization Classification of Tumors. Pathology and Genetics of Tumors of Haematopoietic and Lymphoid tissue. Lyon: International Agency for Research on Cancer; 2001.DISCLOSURE: The following authors have nothing to disclose: Chi Young Jung, Young June JeonNo Product/Research Disclosure InformationKeimyung University Dongsan Hospital, Daegu, Republic of Korea.

Synovial sarcoma in the lung: a case series

Case reports Case 1 was a54-year-old female who presented with a right upper lobe lung lesion. Macroscopic examination showed a 20 mm nodular tumour. Microscopically, a mitotically active, monophasic spindle cell tumour extended into the lung and infiltrated the pleura. Immunohistochemistry was positive for CD99 and BCL2 and negative for CD34. Case 2 was a 49-year-old female who presented with groin, lung and mediastinal lesions. Macroscopically there was a 45 mm lung tumour with a 10 mm subpleural lesion. Microscopic examination showed a mitotically active spindle cell tumour. Immunohisto-chemistry was positive for CD99, BCL2, and b-catenin and negative for CD10, ER and PR. Case 3 was a 37-year-old female who presented with a left-sided pleural mass. Macroscopic examination showed a 135 mm nodular tumour and microscopically a mitotically active spindle cell tumour. Immunohistochemistry was negative for CD34, cytoker-atins and S100. Case 4 was a 43-year-old female who presented with a left lung mass and pleural effusion. There was a 95 mm cystic necrotic lung tumour macroscopically. Microscopy showed closely packed sheets of spindle cells. Immunohistochemistry was positive for CD99 and BCL2 and negative for cytokeratins and S100. Fluorescence in situ hybridisation (FISH) showed t(X; 18) (p11; 911) translocation in all four cases. Diagnosis Synovial sarcoma. Discussion Synovia sarcoma is commonly found in soft tissue. Histologically it is classified into four subtypes: biphasic, mono-phasic, monophasic epithelial and poorly differentiated. Synovial sarcoma occurs predominantly in the extremities. Primary synovial sarcoma arising in lung is rare.

The relationship between platelet endothelial cell adhesion molecule-1 (PECAM-1) and Paraquat induced lung injury in rabbits.

Objective To explore the relationships between the expression of PECAM-1 and the degree of ALI in Paraquat induced lung injury model of rabbits. Method Thirty six adult New Zealand rabbits were randomly divided into three groups: 8 mg/kg (Group A), 16 mg/kg (Group B) and 32 mg/kg ( Group C) according to the dose of Paraquat which were infusion into stomach. After poisoned, the animals were monitored for seven days, and then sacrificed. The upper lobe of lung were removed for HE,Masson staining and immunohistochemisty. The ALl score, fibrosis of lung and expression of PECAM-1 were semiquantitative analyzed. Results Each group has 12 animals suffered from poisoning. The survival time of animals in Group C was (6. 47 ± 0. 99 ) days, shorter than (6. 09 + 1.04) days ( P = 0. 031 ) in Group B and (4. 77 + 2. 04) days ( P = 0. 0 07) in Group A. The ALI score were ( 8. 33 ± 1.03) points in Group A, superior to (9. 83 ± 1.17) points ( P = 0. 047 ) in Group B and ( 11.50 + 1.38) points ( P ＜ 0. 01 ) in group C, Group B vs Group C, P=-0.03o The fibrosis degree of lung was (31.09 +2.05)% in Group A,not severe as (34. 37 ±1.62)% (P=0. 002) in Group B and (36. 54 ±0. 44)% (P ＜0. 01 ) in Group C, Group B vs Group C, P = 0. 026. The Pearson correlation analysis showed the expression of PECAM-1 was negative correlated to ALI score (Coe = -0. 732, P =0. 001 ) and fibrosis degree of lung (Coe = -0. 779, P ＜ 0. 001 ) . Conclusions The expressions of PECAM-1 were significantly decreased in New Zealand after Paraquat poisoned, which were dose dependent, correlated to ALI scored and fibrosis degree of lung, so it may play an important role in the development of lung injured induced by Paraquat. Key words: Paraquat; Acute poisoning; PECAM-1; Acute lung injury

Type II- Pleuropulmonary Blastoma: A case report

Pleuropulmonary blastoma is a rare and aggressive neoplasm typically presents in young children, younger than 5 years, as a pulmonary and/or pleural-based tumor. We reported a case of type-II pleuropulmonary blastoma (PPB) in an 8 month old infant who presented to Al-Khansa'a Maternity Hospital in Western Mosul with a history of repeated attacks of shortness of breath and signs of pulmonary infection unresponsive to treatment. A bronchoscopic examination showed a mass involved and obstructed the orifice of the main bronchial tree of the right upper lung lobe. A thoracotomy was performed; tumor involved the right upper lung lobe, the covering pleural surface and invading the mediastinal structures. Right upper lobectomy was performed. Tumor had cystic and solid components. It characterized histologically by a mixture of primitive blastematous and sarcomatous elements.

Invasion of lung mesenchymal chondrosarcoma into the left atrium via the pulmonary vein detected on transoesophageal echocardiography

A patient with a right upper lobe lung mass presented with a stroke and peripheral embolism. A left atrial mass prolapsing through the mitral valve was seen on transthoracic echocardiogram, but it remained undiagnosed. Transoesophageal echocardiography (TEE) enabled the origin of the left atrial mass ( Panels A and B , Supplementary data, Video 1 ) to be traced to the right upper pulmonary vein. Doppler interrogation of the right upper pulmonary vein suggested a total occlusion. The elongated, multilobular, friable appearance, and the origin of the mass from …

Aspergilloma in combination with adenocarcinoma of the lung

A 60 year old male with a long standing history of smoking was referred to our department for surgery of aspergilloma in right upper lung lobe diagnosed by computed tomography and confirmed by computed tomography guided needle aspiration biopsy. A lobectomy was performed. Histological study of the surgical specimen revealed a pulmonary adenocarcinoma associated with aspergilloma. By presenting this case we suggest that every case of pulmonary aspergillome should be examined for malignancies, especially in smokers.

Complete remission in a patient with metastatic mixed adenocarcinoma/extrapulmonary small cell carcinoma of the prostate

Approximately 10% of all extra-pulmonary small cell carcinoma (EPSCC) arises in the prostate either as de novo mixed adenocarcinoma with small cell components or a pure small cell carcinoma. Extensive disease carries a median survival of about 10 months in retrospective studies. We present a case managed aggressively with concomitant hormonal and chemotherapy, now 36 months without evidence of disease. At a routine physical, a 55 year male was found to have a 5 cm left upper lobe lung mass, invading his 3rd rib. An FNA revealed an adenocarcinoma of unknown primary. His PSA was elevated to 8 ng/mL and a prostate biopsy revealed Gleason 9 adenocarcinoma with neuro-endocrine/SCC components. A bone scan revealed extensive bone metastasis. He was managed aggressively with concomitant cisplatin, etoposide and hormonal therapy and received 73 Gy of radiation to the prostate. PET scans demonstrated marked response to chemotherapy. PSA and chromogrannin levels down trended to normal limits. His most recent PET scan in July 2010 revealed no evidence of disease and is in remission. We present a unique case of metastatic mixed adenocarcinoma/SCC of the prostate, in which the patient survived more than 36 months with complete remission after initiation of aggressive hormonal and chemotherapy. Data on survival in this patient population is limited to case reports, and ordinarily carries a poor prognosis of less than 1 year. In patients with clinical and pathologic features of mixed disease, initiation of early multi-modal therapy is warranted. Additionally, it may be of prognostic significance to biopsy any metastatic lesion.

Emergency department diagnosis of critical aortic stenosis using bedside ultrasonography

Abstract Introduction An 88-year-old woman with a history of coronary artery disease, hypertension, and a history of a large left upper lobe lung mass presented to the Emergency Department (ED) from a nursing home with rapidly progressive shortness of breath and chest pain over 1 day with a rapid decline in mental status. Bedside color Doppler ultrasound para-sternal long-axis examination of the heart revealed severe aortic stenosis. Bedside pulsed-wave and continuous-wave Doppler ultrasound in the apical 5-chamber view revealed critical aortic stenosis using the simplified continuity equation. Conclusion Bedside ED cardiac color Doppler, pulsed Doppler evaluation of the left ventricular outflow tract, and continuous-wave Doppler of the aortic valve were used to assist in the diagnosis of critical aortic stenosis.

Fulminant Unilateral Pulmonary Edema on the Wrong Side

A 55-year-old patient had undergone replacement of the proximal descending aorta at the age of 17 for aortic coarctation. The patient required surgical intervention at the age of 55 for development of a false aneurysm at the distal anastomosis. Surgery was complicated by bleeding from the ruptured false aneurysm into the left upper lung lobe, which had to be resected. Recovery from surgery was uneventful. The patient could be extubated and his cardiopulmonary function was stable. On the 3rd postoperative day, acute decompensation occurred and the patient had to be reintubated for severe hypoxia. Chest X-ray showed massive opacification of the right lung indicating fulminant pulmonary edema. Interestingly, no marked changes of the remaining left lung were observed. The patient was treated with antibiotics intravenously for suspected pneumonia. In addition, diuretics and catecholamines were administered for markedly elevated cardiac preload and acute loss of peripheral vascular resistance. Within only 12 hours, the patient recovered dramatically. Follow-up chest X-ray showed no remaining opacification of the right lung. The patient was extubated and cardiopulmonary function has remained stable. The subsequent postoperative course was uneventful and the patient could be discharged from hospital 4 days later.

An unusual clinical presentation of a rare renal tumour

We report an unusual clinical presentation of renal leiomyosarcoma. A woman, who received renal transplant from her mother, was diagnosed to have leiomyosarcoma in the donated kidney. The mother was found to have a right upper lobe lung mass 10 years later, which was diagnosed as leiomyosarcoma. It is possible that the mother had primary leiomyosarcoma of the donated kidney with micrometastases to the lung 10 years previously, which developed into a lesion in the donated kidney in her daughter. Ten years later, the slow-growing metastatic leiomyosarcoma developed into a lung mass.