Rare cases of pulmonary inflammatory myofibroblastic tumors in adult male patients: a case report

Pulmonary inflammatory myofibroblastic tumors (IMTs) are rarely reported in adult males. Given the low incidence of IMT and the lack of imaging references and pathological guidance, the misdiagnosis rate of IMT is high. In this article, we describe two cases of IMTs in the lungs. Both patients were adult males with lesions in the right lobe, a history of pulmonary tuberculosis, and a long period of refractory intermittent pulmonary inflammation. Our two male patients both experienced intermittent cough symptoms, but pulmonary IMTs were not suspected for a long time. Both patients were diagnosed with pulmonary tuberculosis before IMT was confirmed and treated with isoniazid (H), rifampin (R), pyrazinamide (Z), and ethambutol (E) (HRZE) or isoniazid (H), levofloxacin (L), pyrazinamide (Z), and ethambutol (E) (HLZE) for months. In Case 2, we observed multiple subpleural cord signs in the left lung, soft tissue mass shadows at the apex of the right upper lobe, a thickened interlobular interval, and scattered patches and nodules in the upper right lung. These features are novel in the identification of IMTs. Both of the pathological findings revealed a great deal of myofibroblasts, fibroblasts and collagen fibers in the lower right lung lesion, accompanied by a large number of plasma cells and foam cell infiltration, which were consistent with the features of IMT. The two patients displayed exceedingly different symptoms, computed tomography (CT) imaging features, and pathological results from those reported in traditional records. These findings provide novel references that will extend understandings of this rare disease.