An unusual pulmonary mass.

Accepted 17 April 1996 A 23-year-old woman smoker complained of right-sided chest pain. The patient had no significant personal or family history. She was asymptomatic, and physical examination was unremarkable. Her chest X-ray and thoracic computed tomography (CT) scan are shown in figures 1 and 2. Blood biochemical and haematological examinations were normal, as was abdominal ultrasonography. A tuberculin purified protein derivative (5 IU) skin test was 10 mm in diameter. Several sputum samples were negative for malignant cells and for Mycobacteria. Appropriate microbiological and cytological examinations of a bronchoalveolar aspirate obtained by fiber-optic bronchoscopy were non-diagnostic. A transthoracic fine-needle aspiration of the pulmonary mass yielded abundant necrotic material with clumped hystiocytic cells, epithelioid cells, lymphocytes and rare neutrophils. A diagnostic thoracotomy was performed. The histological section is shown in figure 3.