title: Cystic Pulmonary Myxoid Liposarcoma Mimicking Endobronchial Blood Clot.
abstract: A 71-year-old-man was transferred to our hospital in November 2012 for a bronchial artery embolization in the context of recurrent blood clots obstructing the left lower bronchus. Since June 2012, he had been explored for a cystic hypermetabolic lesion of the entire left lobe, and underwent 3 bronchoscopies and 2 computed tomography scan-guided biopsies, with no success. A fourth bronchoscopy enabled the extraction of a large blood clot (8×1.5 cm) that obstructed the left main bronchus. The pathologic examination of the mucosal biopsy samples was inconclusive, whereas the cytologic examination of the blood clot revealed myxoid liposarcoma. Liposarcomas are the most common histologic types of soft-tissue sarcomas. They preferentially metastasize to the lungs and can appear as cystic mass. Bronchial obstruction by blood clots is not a rare finding on bronchoscopy, their main problem is their removal which could require rigid bronchoscope and large forceps. However, bronchial blood clot containing tumoral process had never been reported before. In conclusion, this case conveys 2 messages. First, pulmonary metastasis of myxoid liposarcoma can appear as cyst secondary to endobronchial tumoral growth. Second, endobronchial blood clots should always be sent for pathologic analysis.
authors.affiliation: *Service de Pneumologie †Service de Chirurgie Thoracique §Service d'anatomo-pathologie, Hôpital Tenon, Université Pierre et Marie Curie ‡Service de Pneumologie, Hôpital Saint-Louis, Université Denis Diderot, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Matthias
authors.initials: M
authors.lastname: Papo
authors.forename: Flora
authors.initials: F
authors.lastname: Crockett
authors.forename: Valérie
authors.initials: V
authors.lastname: Gounant
authors.forename: Jallal
authors.initials: J
authors.lastname: Assouad
authors.forename: Frederic
authors.initials: F
authors.lastname: Schlemmer
authors.forename: Anne
authors.initials: A
authors.lastname: Bergeron
authors.forename: Martine
authors.initials: M
authors.lastname: Antoine
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Naccache
mesh_terms: D000368:Aged; D001984:Bronchial Neoplasms / Q000175:diagnosis*; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D006801:Humans; D018208:Liposarcoma, Myxoid / Q000175:diagnosis*; D008297:Male; D013927:Thrombosis / Q000175:diagnosis*