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Biphasic pulmonary blastoma is a malignant and rare lung neoplasm with a unique histology. It occurs most commonly in the 4th decade of life, and an association with cigarette smoking has been suggested. Approximately 60% of the patients present with non-specific symptoms. On imaging, a solitary, peripherally located, typically unilobar, heterogeneous mass is often seen, which can be quite large at presentation. Enhancing components and areas of necrosis are typical, and some studies report a swirling appearance of the internal soft tissue component. An associated pleural effusion is sometimes noted. Currently, there is no specific or diagnostic imaging finding for this entity. A poor prognosis has generally been reported, and surgical resection remains the preferred treatment.






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The Radiologic and Pathologic Diagnosis of Biphasic Pulmonary Blastoma

Free full text article: The Radiologic and Pathologic Diagnosis of Biphasic Pulmonary Blastoma

Abstract
Pulmonary blastomas are rare malignancies, representing 0.25% to 0.5% of all primary lung neoplasms with often aggressive progression and poor prognosis. Clinical management of pulmonary blastomas depends on histologic subtype, staging, and presentation, and may consist of surgery, chemotherapy, and radiation. Biphasic pulmonary blastoma is a subtype of pulmonary blastoma that exhibits biphasic histology, with both epithelial and mesenchymal malignant elements. We report a case of biphasic pulmonary blastoma in a 33-year-old female with 1 pack per day history of smoking for approximately 16 years, who presented with left-sided pleuritic chest pain on deep inspiration without otherwise significant pat medical history. Imaging evaluation using chest radiography, computed tomography, and magnetic resonance imaging identified a heterogenous, well-circumscribed, left lower lobe mass with extensive necrosis and hemorrhage. No lymphadenopathy or distant metastasis was detected through imaging evaluation. Surgical resection of the tumor followed by histopathological analysis confirmed a biphasic pulmonary blastoma.






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