Inflammatory pseudotumour: A rare tumor of lung
The present case has been presented in the journal Annals of Medicine and Surgery.

A 40-years-old male non-smoker presented to chest outpatient department with complaints of recurrent mild haemoptysis for 2 months, which was progressive in nature. Chest radiograph revealed a 2.5 × 2 cm lesion in the posterior segment of the right upper lobe of the lung. The medical history was noncontributory. A computed tomographic (CT) scan of the chest confirmed the chest radiograph findings; a solid mass was noted in the posterior segment of the right upper lobe of the lung.

There was no hilar lymphadenopathy. Sputum microscopy, culture, and cytological examination were essentially normal. The ESR was 18, the haemoglobin 15.5 g/dL, and the leukocyte count 9.6 × 109/L. The other serum haematological and biochemical results were normal. In view of the patient's ongoing haemoptysis and lack of response to antibiotics he underwent bronchoscopy which revealed a growth in right upper lobe with endobronchial obstruction.

At the same time endobronchial biopsy was taken which was sent for histopathological examination. Microscopically, the biopsy showed a heavy inflammatory cell infiltrate composed predominantly of lymphocytes, with plasma cells and histiocytes. Foamy histiocytes with macrophages were also seen, as well as occasional eosinophils and neutrophils. Focal areas of micro-abscess formation with necrosis were also noted.

A marked degree of fibrosis was present with proliferating myofibroblasts. The histological characteristics were compatible with an inflammatory myofibroblastic pseudotumour. On immunohistochemistry, vimentin, SMA, ALK-1 and desmin were positive, further corroborating the diagnosis. Surgery, for diagnostic and therapeutic purposes, consisted of a right pneumonectomy. The postoperative course was uneventful, the patient was discharged from the hospital one week later and his symptoms improved.

Highlights
• The inflammatory pseudotumor of the lung is a rare entity

• Surgical excision is usually indicated to reach a firm diagnosis and cure

• As preoperative investigation is not diagnostic, excision of the mass is imperative in order to exclude malignancy

• Despite being a benign lesion, its potential for recurrence and local invasion requires complete surgical resection

• Complete resection, when possible, is safe and leads to excellent survival and remains the key to prevent recurrence

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