Inflammatory pseudotumor of the lungs

Two types of presentation of pulmonary inflammatory pseudotumors

Inflammatory pseudotumors are a relatively uncommon pathology of uncertain etiology, generally considered to be reactive in origin. They may be observed in different locations as single or multiple masses. One of the possible forms of presentation is intrapulmonary. Despite its low frequency, this pathology should be considered in the differential diagnosis of lung nodules, even though the histologic results and the imaging tests can become confusing. In addition, pulmonary inflammatory pseudotumors present a low malignancy with good response to surgical treatment as well as to pharmacological therapy, although to a lesser degree. We present a bibliographic review of this pathology based on two cases observed in our hospital. Both patients debuted with non-specific respiratory symptoms and lung nodules on imaging studies that were suspicious for neoplastic processes. After an exhaustive study, the diagnosis of pulmonary inflammatory pseudotumor was reached, with excellent responses to the treatment used in each case.

[Invasive inflammatory pseudotumor of the lung]

Inflammatory pseudotumor of the lung is an uncommon nonneoplastic tumor of unknown origin. It can mimic lung carcinoma. We report a 65-year-old man who presented with productive cough, weight loss, and a heterogeneous right apical lung condensation. This clinical and radiographic presentation suggested a malignant lung tumor. Surgery was performed and the histological examination of the surgical specimen concluded to an inflammatory pseudotumor. A pneumonectomy was performed because of the tumor extension towards the lower lobe and the mediastinum. No recurrence was observed after a 2-year follow-up. Surgery is essential to confirm the diagnosis of inflammatory pseudotumor. Complete resection is the only guarantee to prevent recurrence.