Sažetak
Uvod. Inflamatorni miofibroblastni tumor (IMT) je redak mezenhimalni tumor, nejasne etiologije, koji pokazuje miofibroblastnu diferencijaciju udruženu sa inflamatornim ćelijama. IMT je čest primarni tumor pluća kod dece i nespecifične je simptomatologije kao i radiološkog nalaza. Za definitivnu dijagnozu potrebna je histopatološka i imunohistohemijska obrada materijala dobijenog nakon rigidne bronhoskopije ili nakon kompletne resekcije tumora. Prikaz bolesnika. Bolesnik, star 16 godina, primljen je u našu ustanovu radi nastavka lečenja IMT dokazanog rigidnom bronhoskopijom. Prethodno je bio lečen torakalnom drenažom zbog levostranog pneumotoraksa u drugoj ustanovi. Pošto reekspanzija pluća nije bila ostvarena, učinjena je kompjuterizovana tomografija grudnog koša, a potom i rigidna bronhoskopija kojom je postavljena dijagnoza IMT u distalnom delu levog glavnog bronha. Zbog zahvatanja leve lobarne karine i plućne arterije, učinjena je leva pneumonektomija. Morfološkom i imunohistohemijskom analizom dokazan je IMT. Bolesnik je bio bez recidiva četiri godine nakon operacije. Zaključak. Na IMT treba uvek posumnjati u dečijem dobu jer je jedan od najčešćih primarnih tumora pluća kod dece. Pneumotoraks se može javiti kao manifestacija IMT. Njegova pojava mogla bi biti posledica lezije visceralne pleure u slučaju perifernih tumora ili posledica valvularnog mehanizma kod endobronhijalnih tumora. U cilju postavljanja definitivne dijagnoze, osim histopatološke, neophodna je i imunohistohemijska analiza. Kompletna hirurška resekcija daje najbolju mogućnost za preživljavanje. Zbog mogućnosti recidiva neophodne su dalje kontrole ovih bolesnika.
Ključne reči
diagnosis
lung neoplasms
pneumothorax
pneumonectomy
treatment outcome
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