Purpose or Case Report: In this educational exhibit we will use a series of cases from our institution to review the approach to non-mediastinal solid and solid-like lesions found in the pediatric chest. We will use a multimodality approach and discuss differentials, key imaging features and the pathologic basis of these lesions.
Methods & Materials: Primary lung tumors are rare in the pediatric population. Lung masses in children for the most part are benign. Solid parenchymal lung masses in children can usually be explained by infectious, inflammatory or reactive processes. Therefore, primary lung neoplasms often remain unrecognized and are only diagnosed when a child is unresponsive to conventional therapy. This leads to a delay in diagnosis and overall increased morbidity and mortality. The possibility of lung neoplasm should always be considered in a child with persistent wheezing, cough, hemoptypsis or recurrent pneumonia.
Results: We will use a case based approach to discuss lesions from the following categories:

Tracheobronchial Masses - Hamartoma
Myofibroblastic Tumors – Inflammatory Myofibroblastic Tumor
Neurogenic tumors - Neurofibroma
Vascular lesions – Lymphangiomatosis
Cystic pulmonary airway malformation
Pleuropulmonary Blastoma
Primary Sarcoma - Rhabdomyosarcoma
Primary lung tumors in immunosuppressed and immunocompromised children – Posttransplant Lymphoproliferative Disorder
Granulomatous diseases
Fungal infection
Conclusions: As benign pulmonary neoplasms are far less common than malignant neoplasms in children it is of the utmost importance for the pediatric radiologist to recognize and guide referring clinician when treating a child with persisting pulmonary symptoms. An understanding of the key imaging features of these entities will allow for a timely diagnosis.