case_images: PMC11323557_01
case_images: Female, 57 years old, pulmonary angiomatoid fibrous histiocytoma. On April 27, 2021, a non-contrast CT (A,B) scan showed a space within the bronchus of the right middle lobe (arrow) without evidence of obstructive atelectasis or pneumonia. After 1 week, the patient's condition worsened, manifesting as pulmonary atelectasis. Subsequent axial non-contrast CT scan (C,D) and axial CT enhanced scan (E,F) revealed right middle lobe bronchial obstruction, atelectasis with a soft tissue density shadow (arrow), and significant enhancement of the mass (arrow) as well as mediastinal enlarged lymph node shadows.
case_images: fmed-11-1415042-g001.jpg
case_images: PMC11323557_01_fmed-11-1415042-g001.jpg
case_images: fig1
case_images: The patient underwent a CT examination in the outpatient department of our hospital before starting any medical treatment (Figure 1). As depicted in Figure 1, a nodular mass was identified in the middle lobe of the right lung.
case_images: Female, 57 years old, pulmonary angiomatoid fibrous histiocytoma. (A) whole body MIP, (B) axial PET, (C) axial CT, (D) axial fusion. The 18F-FDG PET/CT revealed right middle lobe atelectasis and a 2.2 cm x 2.5 cm soft tissue density nodule within the bronchus of the right middle lobe of the lung. The density was uneven, with clear boundaries, and there was increased glucose metabolism, with an SUVmax of 11.2 (arrow).
case_images: fmed-11-1415042-g002.jpg
case_images: PMC11323557_01_fmed-11-1415042-g002.jpg
case_images: fig2
case_images: The chest CT scan (Figure 2) revealed a nodular soft tissue density shadow in the bronchus of the right middle lobe, accompanied by bronchial obstruction and atelectasis of the right middle lobe.
case_images: Female, 57 years old, pulmonary angiomatoid fibrous histiocytoma. (A) HEx100, (B) HEx200. The tumor exhibited mild cell morphology, with fusiform and oval nuclei. Microscopically, the tumor appeared nodular, containing irregular pseudovascular spaces, and some tumor cells displayed atypia. (C,D) A nodular mass (arrow), measuring approximately 2.0 x 3.0 cm, was observed in the bronchus adjacent to the bronchial incision, characterized by its yellow and tough texture.
case_images: fmed-11-1415042-g003.jpg
case_images: PMC11323557_01_fmed-11-1415042-g003.jpg
case_images: fig3
case_images: The 18F-FDG PET/CT imaging (Figure 3) demonstrated a nodular soft tissue density shadow in the bronchus of the right middle lobe of the lung, with uneven density, clear boundaries, and a size of approximately 2.2 cm x 2.5 cm. Bronchoscopy (Figure 3) revealed a nodular mass at the opening of the right middle lobe of the lung, blocking the lumen, and the possibility of bronchial lung cancer was considered. The postoperative pathology (Figure 3) revealed an intermediate soft tissue tumor in the middle lobe of the right lung, considered to be pulmonary angiomatoid fibrohistiocytoma.