Lung carcinoma with diffuse cysts repeatedly misdiagnosed as pulmonary infections and lymphoid interstitial pneumonia: A case report

作者全名："Li, Yishi; Yuan, Jinhe; Lu, Junyu"

作者地址："[Li, Yishi] Chongqing Med Univ, Affiliated Hosp 1, Pulm & Crit Care Med, Chongqing, Peoples R China; [Yuan, Jinhe; Lu, Junyu] Chongqing Fifth Peoples Hosp, Pulm & Crit Care Med, Chongqing, Peoples R China; [Yuan, Jinhe] Chongqing Fifth Peoples Hosp, Pulm & Crit Care Med, 24 Renji Rd, Chongqing 400000, Peoples R China"

通信作者："Yuan, JH (通讯作者)，Chongqing Fifth Peoples Hosp, Pulm & Crit Care Med, 24 Renji Rd, Chongqing 400000, Peoples R China."

来源：MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001156361800064

JCR分区：Q2

影响因子：1.3

年份：2024

卷号：103

期号：5

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结束页：　

文献类型：Article

关键词：adenocarcinoma; case report; cystic disease; lung; lymphoid interstitial pneumonia; rEBUS-TBCB

摘要："Introduction:Diffuse cystic lung diseases comprise a heterogeneous group of pulmonary disorders, with most cases being benign and malignant instances being rare.Case report:We present an unusual case of lung adenocarcinoma characterized by the progressive diffusion of cystic lesions. The patient, initially diagnosed with a pulmonary infection and lymphoid interstitial pneumonia, underwent repeated misdiagnoses. Ultimately, the diagnosis was confirmed using radial endobronchial ultrasound-guided-transbronchial cryobiopsy (rEBUS-TBCB). A 44-year-old male was admitted to the hospital with a persistent cough and expectoration of bloody sputum for over 6 months. Thoracic computed tomography revealed widespread cystic lesions and nodules. Despite multiple misdiagnoses, rEBUS-TBCB successfully confirmed the presence of lung adenocarcinoma and identified an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) E13:A20 gene rearrangement. The patient was subsequently transferred to a local hospital for oral targeted drug therapy, which resulted in a favorable response.Conclusion:In conclusions, transbronchial lung biopsies often provide inadequate specimens for confirming diffuse cystic lung diseases. In contrast, the utilization of rEBUS-guided TBCB offers superior diagnostic capabilities, as it enables the collection of larger lung biopsies with higher diagnostic yields and fewer complications compared to surgical lung biopsy."

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