A Case Report of Inflammatory Myofibroblastic Tumor: A Rare Benign Lung Tumor.

Inflammatory myofibroblastic tumors (IMTs) of the lung are a rare type of mesenchymal tumors that tend to occur more in the lungs of children. They are extremely rare in adults. IMTs require extensive pulmonary resection because they are commonly locally invasive. The key to preventing recurrence is complete resection, and the prognosis is excellent after surgery. We report a case of a patient with an inflammatory pseudotumor of the lung. The patient is a 27-year-old female who presented with a dry cough. A chest radiograph and computed tomography showed a lesion in the left main bronchus and near-total left lung collapse. As surgery was necessary to establish the diagnosis, left pneumonectomy was performed followed by a histological examination of the surgical specimen which confirmed inflammatory pseudotumor.

Pleural and serum markers for diagnosis of malignant pleural effusion.

BACKGROUND: Differentiation between benign and malignant exudative pleural effusion remains a clinical challenge. Recently, several markers have been reported to increase the diagnostic accuracy of malignant pleural effusion, with controversial results. METHODS: Patients with exudative pleural effusion were divided into 2 groups: a malignant pleural effusion group (39 patients) diagnosed by malignant cells in pleural fluid cytology or by malignant infiltration of the pleura on pleural biopsy, and a benign pleural effusion group (51 patients) with neither malignant cells in pleural fluid cytology nor malignant infiltration of the pleura on pleural biopsy. Matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 were determined in both serum and pleural fluid samples, using commercially available enzyme-linked immunosorbent assay kits. RESULTS: The etiology of malignant pleural effusion in the malignant group was breast cancer in 43.6% and bronchogenic carcinoma in 25.6%. There was a statistically significant difference between the 2 groups regarding sex, with more males in the benign group. There was no significant difference between groups regarding age. The median levels of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 were higher in the malignant group than in the benign group, and the differences were highly significant in both pleural fluid (p < 0.001) and serum (p < 0.001). CONCLUSION: Matrix metaloproteinase-9 and tissue inhibitor of metalloproteinase-1 in serum and pleural fluid samples might be valuable markers for differentiating benign from malignant pleural effusions.

Indicators for surgical intervention in thoracic empyema in children.

OBJECTIVES: To determine predictors for surgical intervention of thoracic empyema in children, and its associated morbidity. METHODS: We conducted a retrospective review of medical records of children with empyema thoracis admitted in the Maternity and Children Hospital, Al Madinah Al Munawwarah, Saudi Arabia between January 2007 and January 2012. The data extracted included: socio-demographic data, clinical data, method of treatment, and follow up data. According to the introduced therapeutic methods, a total of 62 patients were divided into 2 groups; patients treated with chest tube (CT) insertion (51 cases), and 11 cases that required thoracotomy (TH); groups were compared to determine predictors for thoracotomy. RESULTS: Of 62 patients, 37 were females and 25 were males. In terms of age, side of lesion, presence of cough, or dyspnea, both groups were homogenous. Both groups had significant differences for duration of complaint (TH and CT) (13.5±6.5 days versus 10±3.6, p=0.005), presence of fever (90.2% versus 36.4%, p less than 0.001), history of recurrent chest infections (90.9% versus 37.3%, p=0.001), and radiological findings. However, it was not evident that any of these variables influenced treatment decision except absence of fever, which was significantly less in patients treated with thoracotomy. CONCLUSION: No specific indicator was found to increase expectancy for surgical intervention as a treatment choice, except the absence of fever, which may reflect the delayed referral and prolonged use of antibiotics and cannot be interpreted truly without caution as an indicator for surgical intervention.