Clinical-pathologic conference in general thoracic surgery: Pulmonary artery fibrohistiocytic tumor in a child Thorsten Walles, MD, Paolo Macchiarini,

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Presentation transcript:

Clinical-pathologic conference in general thoracic surgery: Pulmonary artery fibrohistiocytic tumor in a child Thorsten Walles, MD, Paolo Macchiarini, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 128, Issue 2, Pages 319-322 (August 2004) DOI: 10.1016/j.jtcvs.2003.11.013

Figure 1 Thoracic computed tomography at admission showing an endoluminal tumor obstructing the retrocaval portion of the right pulmonary artery and extending distally to include the arterial branches of the right upper lobe. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 319-322DOI: (10.1016/j.jtcvs.2003.11.013)

Figure 2 Helical computed tomography scan showing coronar slides of the thoracic cavities. The tumor is located in the upper mediastinum and infiltrates the right pleural cavity. Notice the different density values indicating intense tumor vascularization from the surrounding bronchial arteries. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 319-322DOI: (10.1016/j.jtcvs.2003.11.013)

Figure 3 Operative view after arteriotomy on behalf of the Boyden artery and the extraluminal protrusion of a gelatinous tumor. SVC, Superior vena cava. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 319-322DOI: (10.1016/j.jtcvs.2003.11.013)

Figure 4 Standard hematoxylin and eosin staining of the tumor samples (100× [A], 200× [B], and 400× [C] magnification). Note the dense cords of spindle cells with oval and vesicular nuclei with prominent, sometimes eosinophile, nucleoli. The cytoplasm is rather broad. A rhythmic pattern, sometimes including whorls, can be observed, as well as a multifocal lymphocytic infiltrate. The tumor is very well vascularized. Mitotic count is not elevated, and there is no necrotic tumor tissue. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 319-322DOI: (10.1016/j.jtcvs.2003.11.013)

Figure 5 Ki-67–specific staining (100-fold magnification). The growth fraction of tumor cells is between 12% and 35%. The Journal of Thoracic and Cardiovascular Surgery 2004 128, 319-322DOI: (10.1016/j.jtcvs.2003.11.013)

Figure 6 A, The tumor shows a marked reaction to the mesenchymal marker vimentin (vimentin immunostaining; 200-fold magnification). However, there are areas (B) that express keratin (stained with the epithelial marker KL-1; 100-fold magnification). The Journal of Thoracic and Cardiovascular Surgery 2004 128, 319-322DOI: (10.1016/j.jtcvs.2003.11.013)