Lung mass in a 28-year-old male: A case report of a rare tumor (original) (raw)
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Lung adenocarcinoma mimicking pulmonary fibrosis-a case report
BMC Cancer, 2016
Background: Lung cancer is usually presented with cough, dyspnea, pain and weight loss, which is overlapping with symptoms of other lung diseases such as pulmonary fibrosis. Pulmonary fibrosis shows characteristic reticular and nodular pattern, while lung cancers are mostly presented with infiltrative mass, thick-walled cavitations or a solitary nodule with spiculated borders. If the diagnosis is established based on clinical symptoms and CT findings, it would be a misapprehension. Case presentation: We report a case of lung adenocarcinoma whose symptoms as well as clinical images overlapped strongly with pulmonary fibrosis. The patient's non-productive cough, progressive dyspnea, restrictive pattern of pulmonary function test and CT scans (showing reticular interstitial opacities) were all indicative of pulmonary fibrosis. The patient underwent a treatment consisting of corticosteroids and antibiotics, to no avail. Histopathology of the lung showed that the patient suffered from mucinous adenocarcinoma. Albeit the immunohistochemical staining was not consistent with lung adenocarcinoma, tumor's morphological characteristics were consistent, and were used to make the definitive diagnosis. Conclusion: Given the fact that radiography cannot always make a clear-cut difference between pulmonary fibrosis and lung adenocarcinomas, and that clinical symptoms often overlap, histological examination should be considered as gold standard for diagnosis of lung adenocarcinoma.
A Case of Lung Cancer Developing in the Background of Progressive Massive Fibrosis
Respiratory Case Reports, 2022
Pneumoconioses are parenchymal lung diseases caused by dust accumulation in the lungs and the resulting tissue reaction. A 60-year-old male patient was admitted to our clinic with complaints for 3 months of weakness, fatigue and constant pain in the right arm that did not change with movement. His professional history revealed employment in glazing processes in the ceramics industry for 28 years, while his medical history included pneumoconiosis and coronary artery bypass surgery in 2015. A recent postero-anterior chest X-ray had revealed increased opacity in the apical region of the right lung compared to a radiograph taken 3 years earlier. A highresolution thorax computed tomography of the lungs was performed revealing a 5 cm diameter mass lesion in the upper lobe of the right lung, although no differentiation between the mass and progressive massive fibrosis (PMF) could be made. Thoracic magnetic resonance imaging was performed after mass development was suspected on the basis of PMF, and a malignant lesion that was hyperintense compared to muscle and PMF tissue was observed in the apical segment of the right lung upper lobe on T2W images. No endobronchial lesion was observed in the patient on bronchoscopy, while a transthoracic biopsy performed on the hyperintense area was reported as adenocarcinoma. We present a case of PMF pneumoconiosis presenting with lung cancer.
A very rare presentation of lung cancer
Medicine, 2019
Rationale: Acrometastases of the hand are an unusual sign of lung cancer onset and may often be mistaken for other benign disorders, thus delaying diagnosis and treatment. Patient concerns: A 58-year-old man presented at the Rheumatology Clinic with a lump in the distal phalanx of the right index finger associated with intense pain, swelling, rib pain, and hemoptysis. Diagnoses: Given the clinical manifestations, an x-ray of the right hand was performed, and it revealed an osteolytic lesion in the distal phalanx of the right index finger. The subsequent CT of the thorax and abdomen showed a lung tumor, osteolytic lesions in the ribs, sternum, and the thoracic spine. Interventions: Amputation of the phalanx was decided on account of intense pain refractory to NSAIDs and opioids. Pathology assessment established the diagnosis of bone metastases secondary to lung adenocarcinoma. The patient underwent 6 cycles of first-line palliative chemotherapy with cisplatin and gemcitabine with partial response according to the RECIST 1.1. criteria. EGFR and ALK testing were not available at the time. A year later, the patient presented with progressive disease, which lead to 6 more cycles of chemotherapy with docetaxel. The disease progressed during chemotherapy and the patient was switched to erlotinib. Outcomes: After 7 months of anti-EGFR treatment, the patient passed away due to disease progression, thus having an overall survival of 25 months. Lessons: On rare occasions, acrometastases of the hand may be the first manifestation of a lung cancer and, as such, they must be taken into consideration in the differential diagnosis of rheumatologic disorders. They are a poor prognosis marker, but some cases like this one can have a better survival than reported in the literature, most likely due to that particular cancer's biology. Abbreviations: ALK = anaplastic lymphoma kinase, CT = computed tomography, EGFR = epidermal growth factor receptor, NSAIDs = nonsteroidal anti-inflammatory drugs, RECIST = response evaluation criteria in solid tumors, TTF-1 = thyroid transcription factor 1.
Acta clinica Croatica, 2014
Pulmonary tumorlets are small, often multiple nodular proliferations of pulmonary neuroendocrine cells. They are common incidental findings in chronic inflammatory pulmonary diseases. They can also be found in normal lung parenchyma and as one part of the continuum known as diffuse idiopathic pulmonary neuroendocrine cell hyperplasia. In many cases, they are incidental histologic findings of no importance or clinical consequences, or they can be associated with a very slow progression of either obstructive or mixed obstructive/restrictive impairment with good prognosis. Only rarely, they metastasize to an adjacent lymph node or produce ectopic neuroendocrine products. When found during diagnostic examination, they represent a doubt to be a malignant tumor until proven otherwise, which is often impossible without biopsy or surgical removal of the adjacent lung lobe. Hereby, we present a patient with a persistent nodular lung structure after being treated for nonspecific symptoms, cou...
An Unusual Presentation of Aggressive Primary Invasive Adenocarcinoma of Lung
C68. THORACIC ONCOLOGY CASE REPORTS II, 2020
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Pulmonary Tumourlets: Case Report and Review of Literature
The Indian journal of chest diseases & allied sciences, 2015
We report a case of tumourlets of the lung associated with carcinoid and neuroendocrine cell hyperplasia, found incidentally in a 30-year-old woman, who underwent bullectomy for pneumothorax. These lesions are histologically similar to carcinoid, but differ in molecular pathogenesis about which little is known. Their nature and significance is debated. Here, we point out the importance of histological, clinical, and diagnostic aspects and follow-up to have evidence of eventual malignant evolution.
A case report of a pulmonary metastasis of a polymorphous low-grade adenocarcinoma
Diagnostic cytopathology, 2015
Herein we report the cytologic findings of a metastatic polymorphous low-grade adenocarcinoma (PLGA) to the lung and briefly address the differential diagnosis. PLGA is reputedly an indolent tumor arising mainly in the minor salivary glands. 1 However, there have been a handful of case reports or small case series documenting aggressive local recurrences as well as distant metastasis. 2-6 Our patient is a 43-year-old female with a 1.0 cm hard palate lesion that was discovered during a dental examination. The lesion was initially thought to be a cyst and was followed for two years until she developed pain. A biopsy was performed at an outside institution and was sent to the University of Virginia (UVA) in-consultation. A diagnosis of PLGA was rendered and the patient underwent a maxillectomy (Figs. 1a and b). Six months following the procedure she was noted to have bilateral metastatic disease to her cervical lymph nodes for which she received chemoradiation. Two left lower lobe nodules were subsequently noted on a surveillance positron emission tomography-computed tomography (PET/CT) scan and the patient elected to transfer her care to UVA for further evaluation. The patient was noted to have an extensive history of smoking and the clinico-radiologic differential for her lung nodules included a primary lung neoplasm, metastatic disease including possibly PLGA and less likely an infectious process. A CT-guided biopsy with fine-needle aspiration was recommended for further assessment. Rapid on-site assessment utilizing Diff-Quik staining revealed a monotonous, tumor cell population arranged in papillary, cribriform, tubular, and solid patterns (Figs. 2a and b). Scant, focal,
An unusual presentation of metastatic adenocarcinoma of lung: a case report
Cases Journal, 2009
We report an unusual patient with primary adenocarcinoma of lung causing malignant pleural and pericardial effusions. The diagnosis was made only at autopsy as his staging computed tomography scan of chest was negative for an obvious mass lesion within the lung or pleura. Prior to his death, his symptoms were erroneously managed as left ventricular failure and community-acquired pneumonia.