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Disorders of the Mediastinum: Pleura and Chest Wall |

Primary Pleural Primitive Neuroendocrine Tumor: A Case Report

Mayuri Johari, MBBS; Deepak Kumar Prajapat, DTCD; Arjun Khanna, DM; Deepak Talwar, DM
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Metro Center for Respiratory Diseases, Noida, India


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A227. doi:10.1016/j.chest.2016.02.235
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SESSION TITLE: Pleura and Chest Wall

SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, April 17, 2016 at 11:45 AM - 12:45 PM

INTRODUCTION: Primitive neuro-ectodermal tumors (PNET), are rare lung tumors. Primary pleural PNET is an extremely rare entity.

CASE PRESENTATION: A 52 year old non smoker female presented with shortness of breath, dry cough and right sided pleuritic pain since one month. CT chest revealed a right effusion with pleural nodules and contralateral mediastinal shift. Pleural fluid aspiration revealed neutrophilic exudate with mesothelial cells. She then underwent medical thoracoscopy which revealed multiple lobulated pleural nodules of varying sizes without lung nodules. Pleural fluid cytospin showed few atypical cell clusters with hyperchromatic nuclei. Fibreoptic bronchoscopy showed normal anatomy. PET CT showed a heterogeneously enhancing lesion (2.8 X 2.0 cm) with increased FDG uptake (SUVmax-14.6) in right pleura with multiple enhancing nodular pleural lesions involving costal and diaphragmatic pleura and station 7 and bilateral 4R lymphadenopathy. Histopathology revealed small round cell proliferation with mitosis of 1-2/HPF. Immuno-histochemistry revealed positivity for NSE, CD56, CD99, S100 and Ki67 of 70 % consistent with PNET. Post thoracoscopy, pleurodesis with Talc was done and ICD removed after 2 days. Patient was advised chemotherpy which was refused, and the patient lost followup.

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