WSI24-474: PPS mystery cases

From MGH Learn Pathology


Request type Cme
Subspecialty Pulmonary Pathology
Set PP teaching set
Topic PPS mystery cases
Presenter Mino-Kenudson, Mari,MD
Date and time Friday, June 26, 2026 12:00 PM


Case Clinical history Requester
Case Clinical history Requester

Case 1


A 70-year-old man with a remote smoking history and no prior cancer history presented with severe right upper lobe (RUL) pneumonia. Diagnostic investigations were initiated after persistence of RUL atelectasis following a course of antibiotics leading to the finding of a 2.1 cm RUL endobronchial mass with an SUV of 2.8. An endobronchial biopsy of the mass was performed. Mm768

Case 2


A 48-year-old man presented with a round lesion in the lower lobe of the left lung. His medical history was notable for p16-positive squamous cell carcinoma of the tonsil with molecular pathologic evidence of a high-risk HPV type which had been treated with radiation therapy one year earlier. Two years previously he had also been diagnosed with squamous cell papillomas of the soft palate uvula and tonsil with evidence of HPV type 11 infection. Wedge resection of segment 8 of the left lung was performed. Mm768

Case 3


A 67-year-old man with a past medical history significant for dyslipidemia and hypothyroidism presented with progressive dyspnea of two months’ duration. A chest radiograph demonstrated a left-sided pleural effusion. Subsequent magnetic resonance imaging (MRI) of the thorax revealed in addition to the pleural effusion a mass in the anterior mediastinum associated with pleural nodules. A biopsy of a pleural nodule was performed. Mm768

Case 4


A 70-year-old never-smoker with familial pulmonary fibrosis premature graying since his 30s and opioid use disorder underwent bilateral lung transplant for progressive fibrosing ILD initially classified as IPAF. Occupational history was notable for more than two decades of indoor traffic-signal assembly without respiratory protection. Mm768

Case 5


A 65-year-old woman with a past medical history of diabetes mellitus hyperlipidemia and recent cardiovascular accident with left sided weakness and an incidentally discovered right lower lobe lung mass; biopsy showed an atypical spindle cell neoplasm and tumor was excised. Mm768

Case 6


A 74-year-old man former smoker presented for biopsy of a 1.2 cm right lower lobe spiculated nodule. A biopsy of the nodule was performed. Mm768