Pulmonary anthracosis mimicking lung metastases in pediatric rhabdomyosarcoma.
Although childhood rhabdomyosarcoma typically metastasizes to lungs, various processes may mimic metastatic etiology. Described herein is the case of an 8½-year-old boy with orbital embryonal rhabdomyosarcoma (RME) in whom three small foci were detected within both lungs on computed tomography. The lesion number and size, however, did not fulfil the Cooperative Weichteilsarkom Study Group 2006 protocol criteria for lung metastasis. Chemotherapy for localized RME produced primary tumor regression and vanishing of the left lung lesion. Two lesions in the right lung remained unchanged. On thoracoscopy multiple minute nodules disseminated in both lungs were detected. Histopathology excluded RME spread but indicated anthracosis in the lung parenchyma and intrapulmonary lymph nodes. Heavy smoking by parents and previous home furnace combustion appeared to be predisposing factors. Uncommon non-malignant intrapulmonary diseases, including anthracosis, should be considered when staging pediatric cancer.
Children's Hospital of Michigan, Detroit, Michigan, USA.
Gabrielle
G
Karpinsky
Department of Pediatrics, Hematology and Oncology, University Clinic Center, Gdansk, Poland.
Malgorzata Anna
MA
Krawczyk
Department of Pediatrics, Hematology and Oncology, University Clinic Center, Gdansk, Poland.
Aleksandra
A
Fatyga
Department of Pathology and Neuropathology, Medical University of Gdansk, Gdansk, Poland.
Ewa
E
Izycka-Swieszewska
Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
Miroslawa
M
Dubaniewicz-Wybieralska
Blackpool Victoria Hospital, Blackpool, Lancashire, UK.
Dagmara
D
Szmyd
Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Gdansk, Poland.
Monika
M
Luboch-Furmanczyk
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland. ebien@gumed.edu.pl.
Ewa
E
Bien
D055008:Anthracosis / Q000150:complications* / Q000175:diagnosis; D001706:Biopsy; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D009918:Orbital Neoplasms / Q000150:complications* / Q000175:diagnosis; D018233:Rhabdomyosarcoma, Embryonal / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
benign lung lesion; child; embryonal rhabdomyosarcoma; lung metastasis; pulmonary anthracosis