History and clinical findings: A 42-year-old woman, a smoker for many
years, had suffered from dry cough for some time. She was admitted bec
ause of haemoptyses, the first one month previously. Physical examinat
ion was unremarkable. Investigations: Chest radiography in two planes
showed no abnormality. Computed tomography revealed a space-occupying
lesion adjacent to the right main bronchus, strongly suspicious of a c
entral bronchial carcinoma. Bronchoscopy showed a smoothly circumscrib
ed tumour in the upper lobe bronchus which almost occluded its lumen.
Multiple biopsies failed to establish the benignity/malignity of the t
umour. Treatment and course: The tumour was removed by upper lobe rese
ction. There was no macroscopic intraoperative evidence of infiltratio
n. Histology provided the surprising diagnosis of a benign neurofibrom
a. Conclusion: Thoracotomy should, if at all possible, be performed wh
enever biopsy of a pulmonary mass fails to establish its benignity. In
trapulmonary neurofibroma is very rare, unless it is part of v. Reckli
nghausen's disease.