Case 1 is an 11-year male who presented with a history of progressive haemoptysis for a 1-year duration. On presentation, he was well nourished with no other symptoms.
He was previously treated for 6 months for unconfirmed pulmonary tuberculosis (PTB) at the age of 8 years based only on suggestive radiology.
Chest examination revealed dullness to percussion over the right upper zone anteriorly with decreased air entry over that region. Frontal and lateral chest radiographs showed a well-circumscribed opacity within the right tracheobronchial angle (Fig. 1a and b). Contrasted CT chest confirmed a well-defined, heterogeneously enhancing right paratracheal mass with foci of coarse intralesional calcification and intraluminal invasion into the right main bronchus (Fig. 1c and d). Flexible bronchoscopy showed an infiltrative mass at the entrance of the right upper lobe bronchus (Fig. 1e). This lesion was close to the carina so extensive biopsies were done around the lesion to exclude mucosal involvement.
Histopathology of the biopsy showed features consistent with mucoepidermoid carcinoma. The atypical fragments of tissues showed cells with intracytoplasmic mucin on Alcian blue PAS stain. On immunohistochemistry, the cells were positive for CK7 and scattered cells showed positivity for p63.