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D lymphocytes in tumor fibrous septae and adjacent lung tissue which might be the anti-tumor reaction of immune system. As to EMP, the neoplastic cells are similar to normal plasma cells with very few lymphocytes. Last, our case should also be differentiated from primary pulmonary sarcomas. Pulmonary myxoid liposarcoma is multinodular-architecture in myxoid stroma with Vimentin and S-100 positive which is similar to EMC, however, lack of lipoblasts and plexiform capillary network exclude the diagnosis [9]. Immunostains can be helpful to rule out rhabdomyosarcoma, leiomyosarcoma. Primary and metastatic chondrosarcoma of lung have been documented, and the multilobular neoplasm with chondroid and myxoid matrix which is positive to Vimentin and S-100, negative for epithelial markers might cause the confusion with EMC [10]. In this case, absence of predominant chondromatous lesion helps to exclude chondrosarcoma. Pulmonary carcinosarcoma is ruled out for lack of carcinomatous component [11]. Although EMC is most common in the soft tissues of the PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/15501003 extremities, in fact, the primary site can be anywhere in the body [1]. To our knowledge, no case of EMC arising in lung has been reported to date. Primary EMC of the pleura has been described by Goetz et al. [12]. From the CT scan, a parenchymal mass of left upper lobe can be found with distinct margin from the intact visceral pleura, which were also proved by microscopic examination on cut section of tumor. We suggest that the origin might be primitive mesenchymal cell, or associated with the tracheobronchial cartilage [13,14]. Anemia is one of the characteristics in this patient which has not been reported previously in EMCs.Patients afflicted with malignancy often develop anemia, and some cytokines, particularly TNF-,TGF-,IFN-, IL-1,are found increasing in many malignant diseases [15,16]. The function of these cytokines is related to retention of iron in the reticuloendothelial system, gastrointestinal tract and liver and exert inhibitory effects on erythroid precursors [17]. As in our case, expression of IFN- in tumor cells, significant in excessive type IFN signaling, inhibits erythropoiesis through decreased BclXL expression level and enhanced apoptosis of erythroblasts [18]. Also, negative bone marrow cytology rules out occurrence of primary hematological malignancies, such as multiple myeloma. It is intriguing that the anemia was corrected just after the removal of the tumor, suggesting that the cause of anemia relies on the tumor itself. EMC shows a tendency to affect patients beyond their fifth decade [19]. EMC was initially viewed as a lowgrade sarcoma with prolonged and indolent clinical course, but recent studies found its unfavorable prognosis with high rate of recurrence and metastases [20]. Significant in the past history was that our 51-year-old patient had a left lung nodule examined by routine chest x-ray check for around 10 years, which was in accordance with those previous reports. Since EMC has a high rate of recurrence and metastases, and the death caused by tumor often occurs in a long postoperative period, sometimes more than 10 years after diagnosis, so we suggest that frequent and long-term follow up Capecitabine is needed for our patient.Conclusion Our case is the first case of EMC located in the lung. It highlights the possibility and difficulty of diagnosis of this rare tumor in the lung, especially in the patients with history of long-term and slowly-growing lung nodule. Characteri.