FERRUGINOUS BODIES IN LYMPH NODES

TOPIC: Lung Pathology TYPE: Medical Student/Resident Case Reports INTRODUCTION: Ferruginous bodies are histological findings often related to asbestos exposure and associated with mesothelioma adenocarcinoma of the lung. They classically found on biopsy lung tissue. However, they rarely in lymph nodes. We present a case diagnosed node incidental ferruginous bodies. CASE PRESENTATION: A 77 year old male presented unstable angina had coronary artery bypass graft surgery. Workup included CT chest that revealed an 2.3 cm mass left lower lobe several indeterminate nodules up 8 mm size. PET/CT showed was hypermetabolic. He eventually readmitted for acute respiratory distress have bilateral pleural effusions. Cytology fluid negative malignancy after having thoracentesis each days apart. discharged home. repeat 6 months later unchanged stable 7 nodule right lobe. No mediastinal lymphadenopathy noted. underwent guided percutaneous core be well-differentiated adenocarcinoma. bronchoscopy endobronchial ultrasound fine needle aspiration paratracheal subcarinal adenopathy multiple crystals is currently being evaluated by oncology appropriate treatment. DISCUSSION: The rare finding should raise concerns possible heavy exposure. Alveolar macrophages (AM) typically first phagocytes encounter inhaled debris such as asbestos. Once mineral particle fibers phagocytosed, iron protein complexes coat turn into body. Although AM thought restricted alveoli, been shown transport antigens nodes [1]. This one mechanism explain this unlikely CONCLUSIONS: When evaluating pulmonary biopsy, clinicians remain aware can outside parenchyma. Currently there little available data clinical significance not understood. Further studies warranted. REFERENCE #1: Kirby AC, Coles MC, Kaye PM. pathogens draining J Immunol. 2009;183(3):1983-1989. DISCLOSURES: relevant relationships Christopher Rosse, source=Web Response