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case_images: (a) H&E stain reveals a well-circumscribed mass composed of numerous plasma cells and lymphocytes in a background of dense fibrosis. (b) In-situ hybridization for kappa (left) and lambda (right) light chains shows a polyclonal mix of plasma cells. (c) An immunostain for ALK-1 is negative and ALK FISH is negative for a translocation.
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case_images: PMC9290091_01_10.1177_20363613221106270-fig1.jpg
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case_images: Histopathological examination of the excisional biopsies showed a well-circumscribed lesion with dense fibrosis and numerous plasma cells and lymphocytes (Figure 1).
case_images: CT imaging showing new nodular opacity in the lingula in cross section (a) and coronal plane (b).
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case_images: Five years later the patient developed progression of the nodular opacity in the lingula (Figure 2) similarly to what was seen on initial presentation.
case_images: CT imaging showing resolution of previously seen nodular opacity in the lingula post radiation therapy in cross section (a) and coronal view (b).
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case_images: Both CT and endobronchial ultrasound guided needle biopsies were non-diagnostic, with the biopsy showing only histiocytes and benign bronchial cells (Figure 3). A follow up scan after 3 months showed a partial response and subsequent CT imaging 6 months later (Figure 3) without any further treatment showed near complete resolution of the lesion.