Endobronchial ultrasound-guided Transbronchial needle aspiration (EBUS-TBNA) in simulator lesions of pulmonary pathology: a case report of pulmonary Myospherulosis

Background Myospherulosis develops as the result of a reaction between exogenous lipids and red blood cells (RBC) of the patient, being the latter injured when perceived as a foreign body by the immune system, triggering an intense inflammatory response. Case presentation A 63-year-old man with a hi...

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Bibliographic Details
Published in:BMC pulmonary medicine 2020-09, Vol.20 (1), p.1-246, Article 246
Main Authors: Fernández-Trujillo, Liliana, Sanchez, Santiago, Sangiovanni-Gonzalez, Saveria, Morales, Eliana I, Velásquez, Mauricio, Sua, Luz F
Format: Article
Language:English
Subjects:
Adenocarcinoma
Asymptomatic
Blood
Case Report
Case reports
Case studies
Cellular biology
Diagnosis
Disease
Dyslipidemia
EBUS-TBNA
Erythrocytes
Esophagus
Granuloma
Health aspects
Heart diseases
Immune response
Immune system
Inflammation
Invasiveness
Lesions
Lipids
Lung Cancer
Lung diseases
Lungs
Myospherulosis
Needle biopsy
Pain
Pulmonary disease
Pulmonology
Stains & staining
Tumors
Ultrasonic imaging
Ultrasound
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Summary:Background Myospherulosis develops as the result of a reaction between exogenous lipids and red blood cells (RBC) of the patient, being the latter injured when perceived as a foreign body by the immune system, triggering an intense inflammatory response. Case presentation A 63-year-old man with a history of dyslipidemia, Barret's esophagus, and coronary disease, who was taken to thoracoscopy and left inferior lobectomy due to the presence of a pulmonary mass. A primary pulmonary adenocarcinoma was diagnosed. On follow up a PET-CT was performed, in which a metabolically active lesion was described adjacent to the prior lobectomy, suggesting a local relapse. EBUS-TBNA was then performed, obtaining a sample from which histopathological pattern compatible with myospherulosis was obtained. Conclusions Although it is a rare entity, myospherulosis has a well-defined morphological pattern. By not recognizing myospherulosis as a benign lesion, a patient's risk of invasive cancer can be overestimated. It is a phenomenon found with increasing frequency and has been reported in different tissues, however, this is the first report in the literature of myospherulosis of the lung. Greater awareness is required regarding the existence of this phenomenon. Keywords: Myospherulosis, EBUS-TBNA, Pulmonary disease, Lung Cancer, Case report
ISSN:1471-2466
1471-2466
DOI:10.1186/s12890-020-01284-7