Qureshi RA, Gazney JA, Soorae AS.
Rare Pigmated Tumor of the Lung.
J Pak Med Assoc Jan ;52(4):183-5.

A 74 years old man was referred by a chest physician for resection of an incidentally discovered solitary tumor in right lung. The patient initially presented with non-specific back pain in October 2000. Subsequent chest X-ray and CT scan revealed a well-defined soft tissue mass within the right upper lobe. He was an exsmoker having smoked 40 cigarettes per day between the age of 16 and 44 years and was known to have chronic obstructive pulmonary disease (COPD). During the 1960`s, he worked on the docks and was exposed to asbestos. However, he was reported to have a normal chest X-ray in 1998. His overall clinical assessment was unremarkable and a bronchoscopic examination was essentially normal. At thoracotomy, there was a tumor about 40.5 cm in the posterior segment of right upper lobe which was deemed resectable with right upper lobectomy . Macroscopically a well-circumscribed mass, 40 mm in maximal diameter, that was 32mm from the bronchial margin was noticed. It approached close to, but did not involve the pleural surface. Histology of the tumor revealed a morphologically poorly differentiated malignant neoplasm showing marked pleomorphism with tumor giant cells in places. There was a nesting pattern with some palisading of cells, some of which were epitheloid in appearance and some fusiform. There was considerable amount of pigment within the tumor. The features of the pigment were suggestive of melanin. HMB-45 antigen was also demonstrated within its cells. The morphological features were consistent with malignant melanoma. Extensive examination of the skin, eyes, anorectal region, genitourinary tract and esophagus failed to reveal occult primary lesions. He made uneventful post-operative recovery and is doing well 12 months after the surgery.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com