Primary intrapulmonary neurogenic sarcoma with hypertrophic pulmonary osteoarthropathy and asbestosis.

A case of primary intrapulmonary neurogenic sarcoma with hypertrophic pulmonary osteo-arthropathy and asbestosis is described. The essential histological features of this rare tumour are detailed, and the five authentic cases previously reported are reviewed. The pathogenesis of hyper-trophic pulmonary osteoarthropathy and its occurrence in this case are discussed. After surgical removal of the tumour recurrence appeared in the chest within six months. It responded poorly to radiotherapy, and death from metastases occurred 16 months after operation. Primary neurogenic sarcomas of the lung are among the rarest of tumours. While reports and reviews of intrapulmonary neurogenic tumours have appeared in the literature, very few reports of malignant tumours have been accompanied by adequate histological descriptions and photo-micrographs. Diveley and Daniel in 1951 described the case of a 48-year-old man who died from recurrence of a primary neurogenic. sarcoma of the left lung which had previously been treated by pneumonectomy. each described a further case. Neilson (1958) added another case report and made an exhaustive review of the literature. He emphasized the need for adequate histological descriptions and photomicrographs in reporting all tumours of neurogenic origin, and particularly those arising in the lung, where anaplastic carcinomas can easily be confused with sarcomas. Other cases have been recorded but lack sufficient microscopical detail for the diagnosis of neuro-genic sarcoma to be conclusive. We wish to report a further case of primary intrapulmonary neurogenic sarcoma. It is of particular interest because of its production of hypertrophic pulmonary osteoarthropathy and its association with asbestosis. These two features have not previously been described.