Lung Metastasis , Nephroblastomatosis vs. Neurogenic Mediastinal Tumor (PNET)

Lung Metastasis , Nephroblastomatosis vs. Neurogenic Mediastinal Tumor (PNET)

Left picture: The diagnosis is a metastasis of the left upper lobe of the lung after treatment of a nephroblastomatosis; the metastasis was treated successfully with chemotherapy. The present bulge of the left kidney is from normal kidney tissue. Right picture: The diagnosis is a malignant neurogenic tumor of the grenz ray (PNET).

Left picture (4 pictures from top to bottom): 5.5-year-old boy with respiratory symptoms. Right picture (4 pictures from top to bottom): 2-month-old boy with deterioration of the conditional and nutritional state, and respiratory signs. Left picture: Chest x-ray at the top: A huge mass of the left upper and middle hemithorax is visible with a rounded limitation on the lateral side. Right picture: Chest x-ray at the top: A large mass is recognizable in the right hemithorax with a round edge laterally; in addition, alterations of the structure of the upper ribs can be seen on the dorsal side. Left picture: CT with contrast (second picture from the top): A large mass is recognizable with projection to the upper lobe of the left lung, and a diminution of the left thoracic cavity. Right picture: MRI (second picture from the top): In a sagittal plane a longitudinal-oval paravertebral mass is recognizable on the right side, occupying in the dorsoventral direction half of the thoracic diameter, and showing processi in the rear. Whole-body scintiscan with 99m Tc DTP (third picture from the top): On a dorsal view the mass is localized in the right hemithorax; no skeletal metastases are recognizable. Left picture: CT half a month after beginning of a cytostatic treatment (third picture from the top): The mass is not detectable any more. Right picture: Chest x-ray 1 month after chemotherapy (fourth picture from the top): Apparent regression of the mass and the appearance of minute calcifications in the tumor can be seen, as well as an involution of the alterations of the ribs. Left picture: Ultrasound (and CT with contrast not shown here) 3 1/2 months after cytostatic treatment (fourth picture from the top): A prominence of the intermediary part of the left kidney can be seen appearing like a bulge at the same site.