[A pulmonary tumor that racks our brains!] / Une tumeur pulmonaire à se creuser les méninges !

We report the case of a 74-year-old woman who, as part of the follow-up for two breast cancers, presented a 2cm long lung nodule. A microscopic examination of the biopsy under a scanner showed a proliferation of epithelial appearance but whose immunophenotypic profile did not permit a precise diagnosis (negativity of CK7, GATA3, TTF1, negative estrogen receptors but positive progesterone receptors). Wedge resection surgery was performed. Extemporaneous and definitive microscopic examination showed a well-defined lesion made up of lobules of cohesive-looking cells, frequently forming coils. The tumor cells showed some intranuclear inclusions and a few psammomas while the immunohistochemical study showed diffuse expression of EMA, SSTR2A and progesterone receptor markers and a low proliferation index. A diagnosis of a pulmonary localization of a meningioma was proposed. The radiological assessment of the entire neuraxis did not show any other lesion leading to the final diagnosis of primary intra-pulmonary meningioma. This is an exceptional tumor with a difficult histopathological diagnosis of biopsy material, which must familiar to the pathologists. It is associated with an excellent prognosis. Our observation aims to illustrate the macroscopic and microscopic aspects and to present the data from the recent literature review.

[A case of bronchial mucous gland adenoma: A rare diagnosis that should not be mistaken!] / Un cas d'adénome muqueux glandulaire bronchique : un diagnostic rare à ne pas méconnaître !

We report the case of a 32-year-old man, who was admitted for a recurrent pneumopathy. The thoracic computed tomography revealed a small well-circumscribed lesion of the lower right lobe of the lung. Microscopic examination from the biopsy material of the endoscopy concluded a mucoepidermoid carcinoma. A lobectomy was realized. Microscopic examination revealed the presence of a well-delineated lesion composed of glands and cysts containing mucous and limited by mucous and cylindric and ciliated cells without atypia. The proliferation index was very low. A diagnosis of mucous gland adenoma was made. It is an exceptional tumor and is very difficult to diagnose on biopsy material but should be known by pathologists. It is associated with a good prognosis. The aims of our observation are to present the macroscopic and microscopic features of this tumor and data from recent literature review to better diagnose it. This is also the second observation with molecular details for this entity.