Lung adenocarcinoma mimicking pulmonary fibrosis-a case report

Bakir Mehić, Lina Duranović Rayan, Nurija Bilalović, Danina Dohranović Tafro, Ilijaz Pilav, Bakir Mehić, Lina Duranović Rayan, Nurija Bilalović, Danina Dohranović Tafro, Ilijaz Pilav

Abstract

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.

Keywords: Case report; Diagnosis; Interstitial opacities; Lung adenocarcinoma; Progressive dyspnea; Pulmonary fibrosis.

Figures

Fig. 1
Fig. 1
Computed tomography scan of the thorax with coronal view demonstrating of reticular interstitial opacities
Fig. 2
Fig. 2
Computed tomography scan of the thorax with axial view demonstrating of reticular interstitial opacities with plenty of thick mucus, and thickening of interlobular septa
Fig. 3
Fig. 3
Tissue histology revealed mucinous adenocarcinoma of the lung whose pattern was largely lepidic with smaller foci acinar growth
Fig. 4
Fig. 4
Close-up view of mucinous adenocarcinoma of the lung whose pattern was largely lepidic with smaller foci acinar growth

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Source: PubMed

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