Herein we present a case of a 13-year-old girl who was admitted to the Department of Paediatric Surgery, Traumatology, and Urology in Poznan. She reported chest discomfort, difficulty breathing, and a cough. A month prior to admission she had suffered from a respiratory tract infection. She was delivered at term as a firstborn child with an Apgar score of 10 and a normal birthweight of 3360 g. At the age of three years, she was diagnosed with erythrocyturia. Clinical examination on admission revealed pallor, left side rib prominence, and diminished vesicular breath sounds on the left (from base to shoulder blade angle). X-ray showed atelectasis of a large part of the superior left lobe and obstruction of the bronchus leading to the third segment of the left lung (Fig. 1).
Computed tomography indicated a soft tissue lesion within the bronchus (Fig. 2).
Bronchoscopy was performed, which revealed a pathological mass filling the left main bronchus (Fig. 3).
Despite the initial recanalisation of only the inferior lobar bronchus, the condition of the patient improved, and a week later the procedure was repeated to clear the superior lobar bronchus. Histopathological examination of the mass indicated an inflammatory myofibroblastic tumour. In the following two months, the tumour recurred and caused symptoms of breathing difficulty. Seven subsequent bronchoscopic decongestions were performed. Due to recurrence, a tissue biopsy was repeated and a second pathomorphological centre was involved in the histopathological interpretation of the biopsy sample. Cytomorphology showed typical Touton cells, and immunohistochemistry was negative for CD1a, s-100, and langerin and positive for CD163. With these results, the patient was diagnosed with juvenile xanthogranuloma. She was referred to an oncological centre for consideration of systemic chemotherapeutic treatment with vinblastine or cytarabine. The patient did not undergo chemotherapy due to the risk of adverse effects, and because the pathological mass was of a stable diameter. The tumour will be monitored, and chemotherapy considered at each future evaluation.