WSI24-127: Mystery Case
From MGH Learn Pathology
Request details
- Request type Study
- Subspecialty Pulmonary Pathology
- Set Mystery Case 2024
- Topic Mystery Case
- Presenter Mino-Kenudson, Mari,MD
- Date and time Sunday, June 22, 2025 3:00 PM
Toggle columns: Diagnosis
| Case | Clinical history | Requester | Diagnosis |
|---|---|---|---|
| Case | Clinical history | Requester | Diagnosis |
|
| A 70-year-old woman with a lung nodule in the left lower lobe. | Kx601 | Secretory carcinoma |
|
| A 65-year old man with persistent fever • dyspnea • persistent cough and hemolysis was referred to the multidisciplinary board for interstitial lung diseases. Previous transbronchial biopsies and radiology at a referring center rendered a tentative diagnosis of hypersensitivity pneumonitis. However • based on the unusual clinical course with persistent fever of unknown origin (> 2 months) and low lymphocyte count on BAL • a VATS thoracic biopsy was performed. | Kx601 | Intravascular large B-cell lymphoma involving the lung |
|
| A 40-year-old male never-smoker presented with a 1 year history of progressive dyspnea on exertion • and dry cough for six months • occasional wheezing and chronic fatigue. The patient is an engineer • working as project manager • but reported a history of exposure to engine exhaust • benzene and carbon black in the 90’s. His medical history included ocular migraines and intermittent “hives with stress”. Pulmonary function tests showed an FEV1/FVC of 48% • FEV1 29% and DLCO 44%. Alpha-1 antitrypsin levels were found normal several times. ANA and RF were negative. IgG levels were low • 595. | Kx601 | Panacinar emphysema with small vessel vasculitis. Hypocomplementemic urticarial vasculitis syndrome |
|
| A woman in her 60s with history of heavy smoking (> 40 pack/years) presented with a slowly growing right lower lobe nodule that was found by a low-dose CT screening program. | Kx601 | Clear cell stromal tumor of the lung with YAP1::TFE3 fusion |
|
| A 52-year-old female never smoker was incidentally found to have a 10mm well-circumscribed nodule in the superior segment of the left lung lower lobe by CT scan. The lesion was not amenable to biopsy and the patient underwent a surgical wedge resection. | Kx601 | Pulmonary Benign Notochordal cell tumour |
