Pulmonary IMT

Figure 1

This slice of right lung from 5-year-old boy shows a large tumor (5 cm in extent) infiltrating predominantly the upper and lower lobes. It also involved hilar and mediastinal structures including the pericardium.

Tumor is firm and pinkish-grey with well-defined margins. It obliterates large bronchovascular structures. The surrounding lung appears normal.

Other Histologic Appearances


Figure 2

These images from other cases show other features of this tumor.

This image shows extensive infiltration of the lung by tumor that is partly cellular and partly fibrotic. A piece of cartilage indicates the location of an obliterated bronchus. A few scattered air spaces are lined by respiratory epithelium (non-neoplastic).

Find the bronchial cartilage.


Figure 3

Tumor here has a pushing, rather than infiltrative, boundary with lung. The tumor has spindled cells with little collagen and prominent capillaries. Lymphocytes and plasma cells are scattered throughout, but the inflammatory cells are especially prominent at the edge of the tumor.

The adjacent alveoli (right) show a focal interstitial lymphoid infiltrate.

Figure 4

Here, collagen deposition is prominent. It may become hyalinized (homogeneous and pink) and resemble amyloid. The spindled cells here are heavily infiltrated by lymphoid cells.

Figure 5

Calcification or bone formation may be found, usually in the more fibrotic regions of tumor as shown here (two ovoid, dark areas with fractured calcium).

This change is referred to as dystrophic calcification or bone rather than a metastatic type that occurs in persons with elevated serum calcium levels.

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