PRIMARY PULMONARY SPINDLE CELL SARCOMA: A RARE CASE REPORT AND LITERATURE REVIEW

Abstract

Primary pulmonary spindle cell sarcoma (PPSCS) is an exceptionally rare intrathoracic malignancy with limited cases documented. This report describes a 72-year-old male who presented with persistent cough and weight loss, initially misdiagnosed as pulmonary tuberculosis. Imaging revealed a cavitary mass in the right upper lobe, and bronchoscopic biopsy confirmed a high-grade spindle cell sarcoma of smooth muscle origin. Immunohistochemistry was essential for diagnosis, showing SMA positivity and ruling out epithelial and neural origins. Bronchoscopic intervention achieved partial tumour debulking and symptom relief, followed by systemic chemotherapy with partial radiological response. The absence of distant metastasis and favourable short-term outcome underscore the value of early diagnostic vigilance and multidisciplinary management. This case expands the clinical understanding of PPSCS, especially in TB-endemic regions where misdiagnosis is common. It highlights the critical role of histopathology, immunohistochemistry, and bronchoscopy in diagnosing and managing rare pulmonary tumours.