Gynecomastia is a condition that makes breast tissue swell in boys and men. It can happen when the balance of two hormones in your body is thrown off. Although breasts don’t develop in men the way they do in women, all boys are born with a small amount of breast tissue. Boys’ bodies mostly make a hormone called testosterone, which guides their sexual growth during puberty. But males also make some estrogen -- the hormone that steers sexual growth in girls. When a boy is going through puberty, or when an older man’s body makes less testosterone, the balance of the two hormones changes. Sometimes when that happens, a higher percentage of estrogen causes male breast tissue to swell. About half of adolescent boys and as many as two-thirds of men older than 50 will have this to some degree.

Empyema is also called pyothorax or purulent pleuritis. It’s a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space. Pus is a fluid that’s filled with immune cells, dead cells, and bacteria. Pus in the pleural space can’t be coughed out. Instead, it needs to be drained by a needle or surgery. Empyema can develop after you have pneumonia. Many different types of bacteria may cause pneumonia, but the two most common are Streptococcus pneumoniae and Staphylococcus aureus. Occasionally, empyema may happen after you’ve had surgery on your chest. Medical instruments can transfer bacteria into your pleural cavity.The pleural space naturally has some fluid, but infection can cause fluid to build up faster than it can be absorbed. The fluid then becomes infected with the bacteria that caused the pneumonia or infection. The infected fluid thickens. It can cause the lining of your lungs and chest cavity to stick together and form pockets. This is called an empyema.

Mediastinal teratoma is unusual in children. It is often difficult to diagnose because of its few early symptoms. Rarely, a cystic teratoma may rupture into adjacent structures, such as the pleural space, pericardium, lung parenchyma or tracheobronchial tree [1,2,3,4,5,6], however tumor shape of the previous reported cases was more relatively typical than our present cases.Here, we report a series of three children with recurrent hemoptysis and pleuritis attributed to mediastinal teratoma containing pancreatic tissue (all three patients) and calcification (patients 1 and 2). All these patients were initially suspected to have pneumonia, tuberculosis or empyema, and underwent relevant treatment, but without improvement. The main rarity of these cases was the dynamic imaging findings similar to the developmental process of tuberculosis in patients 1 and 2, the pachypleuritis in the patients 2 and 3, the extremely elevated inflammatory markers in serum and pleural effusion similar to empyema in patient 3, and the extremely atypical tumor shape on chest imaging in all patients especially in patient 2.

A lobectomy is the surgical removal of a lobe of an organ. It most often refers to the removal of a section of the lung, but it can also refer the liver, brain, thyroid gland, or other organs. Every organ is made up of many sections that perform different, specific tasks. In the case of the lungs, the sections are called lobes. The right lung has three lobes, which are the upper, middle, and lower lobes. The left lung has two lobes, the upper and lower lobes. In most cases, surgeons perform a lobectomy to remove a cancerous portion of an organ and to prevent the cancer from spreading. This may not entirely get rid of the disease, but it can eliminate the primary source of it.