Pulmonary By Yoshihiko
in a Child
ULMONARY BLASTOMA is a very rare type of lung tumor. In 1952 Barnard’ described the first report of a rare pulmonary neoplasm which histologically resembled fetal lung tissue. He named it pulmonary embryoma. Spencer’ reported four similar cases which he called pulmonary blastoma because they resembled the histologic pattern of nephroblastoma. Since then there have been 25 reported cases of this type of neoplasm but only two were in children.3,4 We have recently treated a lo-yr-old girl with this neoplasm. CASE A IO-yr-old of a right
monary tuberculosis The patient Examinations angiography,
to the National
lesion had 6 mo previously (Fig.
I). On admission,
was asymptomatic. included
and lung scintigram.
showed the mass previously
1973 for treatment
the mass was larger than the film taken 6 mo before.
rates, and urinalysis
All of these tests were within
limits except that the scan
noted by plain film of the chest. A provisional
tumor was made. Right thoracotomy
2 wk after
found in the right upper lobe. There was no evidence There were enlarged
Fig. 1. (A) AP and (8) lateml roentgenograms was noted. See p. 240 Fig. 1. (C) and (D) .
A mass 3 x 3 cm in diameter it involved
the chest wall or pleura.
6 me before admission
From the Departments of Surgery and Pathology, The National Children’s Hospital, Tokyo.
Addressfor reprint requests: Yoshihiko Kodaira, M.D., The Division of Pediatric Surgery, Department of Surgery, Keio University School of Medicine. 35 Shinanotnachi. Shinjuku-ku, Japan.
0 1976 by Grune & Stratton, Inc. Journal of Pediatric Surgery, Vol. 11, No. 2 (April), 1976
(C) AP and (D)
diagnosis of pulmonary blastoma was made by frozen section. Postoperative course was uneventful. She was discharged 2 wk later. Since then there has been no evidence of recurrence or metastasis. The right upper lobe contained a well circumscribed 3 x 3 cm round soft tumor mass the surrounding lung was atelectatic in its midportion. The cut surface was yellow-white, (Fig. 2).
Epitheliol cells resemble fetal lung tissue. The connective tissue stromo is scanty; there fig. 3. is no sacromatous proliferation. (A) low power x 100. (B) Higher power x 400.
The tumor ciliated
showed both solid and glandular
3). The overall
elements with small epithelial appearance
tive tissue stroma was scanned and composed
without sarcomatous proliferation. of the specimen it did not resemble
cells and columnar
to fetal lung. The
cells at the margin
shaped cells or asteroid
Although there was a small amount of cartilage the appearance of pulmonary hamartoma.
REFERENCES 1. Barnard
11299, 1952 2. Spencer Bact 82:161,
H: Pulmonary 1961
3. Nazari A, Amer-Mokri E, Sarram A, et al: Pulmonary blastoma. Chest 60: 187, 1971 4. Iverson RE, Straehley CJ: Pulmonary blastoma; Longterm survival ofjuvenile patient. Chest 63:436, 1973