Redak slučaj inflamatornog miofibroblastnog tumora udruženog sa pneumotoraksom
Sažetak
Uvod. Inflamatorni miofibroblastni tumor (IMT) je redak mezenhimalni tumor, nejasne etiologije, koji pokazuje miofibroblastnu diferencijaciju udruženu sa inflamatornim ćelijama. IMT je čest primarni tumor pluća kod dece i nespecifične je simptomatologije kao i radiološkog nalaza. Za definitivnu dijagnozu potrebna je histopatološka i imunohistohemijska obrada materijala dobijenog nakon rigidne bronhoskopije ili nakon kompletne resekcije tumora. Prikaz bolesnika. Bolesnik, star 16 godina, primljen je u našu ustanovu radi nastavka lečenja IMT dokazanog rigidnom bronhoskopijom. Prethodno je bio lečen torakalnom drenažom zbog levostranog pneumotoraksa u drugoj ustanovi. Pošto reekspanzija pluća nije bila ostvarena, učinjena je kompjuterizovana tomografija grudnog koša, a potom i rigidna bronhoskopija kojom je postavljena dijagnoza IMT u distalnom delu levog glavnog bronha. Zbog zahvatanja leve lobarne karine i plućne arterije, učinjena je leva pneumonektomija. Morfološkom i imunohistohemijskom analizom dokazan je IMT. Bolesnik je bio bez recidiva četiri godine nakon operacije. Zaključak. Na IMT treba uvek posumnjati u dečijem dobu jer je jedan od najčešćih primarnih tumora pluća kod dece. Pneumotoraks se može javiti kao manifestacija IMT. Njegova pojava mogla bi biti posledica lezije visceralne pleure u slučaju perifernih tumora ili posledica valvularnog mehanizma kod endobronhijalnih tumora. U cilju postavljanja definitivne dijagnoze, osim histopatološke, neophodna je i imunohistohemijska analiza. Kompletna hirurška resekcija daje najbolju mogućnost za preživljavanje. Zbog mogućnosti recidiva neophodne su dalje kontrole ovih bolesnika.
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