title: Pulmonary blastoma: a case report and review of the literature.
abstract: BACKGROUND
  Pulmonary blastomas are a rare aggressive neoplasm comprising 0.25-0.5% of all primary lung tumors and portend a poor prognosis. They display a biphasic histology with mesenchymal and epithelial components. Historically, the term pulmonary blastoma had included both pure fetal adenocarcinomas, pleuropulmonary blastomas as well as the classic biphasic blastomas. However recent World Health Organisation re-classifications separated well-differentiated fetal adenocarcinomas and pleuropulmonary blastomas from the biphasic tumours.
  
  
  METHODS
  We present a case of a systemically well 67-year-old Caucasian male who presented with haemoptysis. Investigations confirmed the presence of a large right-sided lung mass and biopsy identified non-small cell carcinoma. The resected tumour was markedly necrotic revealing a biphasic pattern. It was composed of malignant glandular tissue with sub-nuclear vacuoles, associated with a pleomorphic stromal malignant blastematous component, characteristic of classic biphasic pulmonary blastoma.
  
  
  CONCLUSIONS
  We present a case of a classic biphasic pulmonary blastoma, a rare lung cancer occurring at an earlier age and portending to poorer prognosis than other more common lung cancers. Given the small number of cases and recent re-classification, interpreting the published epidemiology and clinical features of this disease is difficult. Many earlier reports may have included fetal adenocarcinomas (in particular high grade variant), which need to be considered when discussing treatment and prognosis with newly-diagnosed patients. Much could be gained from a central registry of individual experiences to improve our understanding of this rare lung cancer.
authors.affiliation: St, Vincent's University Hospital, Elm Park, Dublin 4, Ireland. robertsmyth23@gmail.com.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Smyth
authors.forename: Aurelie
authors.initials: A
authors.lastname: Fabre
authors.forename: Johnathan D
authors.initials: JD
authors.lastname: Dodd
authors.forename: Waldemar
authors.initials: W
authors.lastname: Bartosik
authors.forename: Charles G
authors.initials: CG
authors.lastname: Gallagher
authors.forename: Edward F
authors.initials: EF
authors.lastname: McKone
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D018202:Pulmonary Blastoma / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed