Round pneumonia: a rare condition mimicking bronchogenic carcinoma. Case report and review of the literature

Abstract

CONTEXT: Round pneumonia is a condition usually described in children, with few reports addressing adult patients. It is an oval-shaped consolidation that, due to its radiological appearance, simulates bronchogenic carcinoma. Its evolution tends to be benign, although diagnostic dilemmas have sometimes required exploratory thoracotomy. Deaths caused by this condition have even been reported. To the best of our knowledge, there have been 31 previous cases of round pneumonia in adults reported in the English and Portuguese-language literature, of which only one was completely asymptomatic. CASE REPORT: The case of a 54-year-old female patient presenting a lung mass found on routine imaging evaluation is reported. Respiratory symptoms and signs were absent, but the patient had a significant history of smoking. Her physical examination gave normal results. On chest radiographs, a mass located in the middle third of the right lung was observed. Three weeks after the initial evaluation, the patient was admitted for a complete evaluation and for staging of a pulmonary malignancy, but repeated chest radiographs showed complete resolution.

A Disappearing Lung Mass: Round Pneumonia

“…1 Perhaps the true incidence in adults may be higher, as many cases get treated with antibiotics prior to imaging. Less than 1% of pneumonia in adults are round in shape, mimicking lung cancer.…”

“…1 Others argue that the pores of Kohn and the canals of Lambert in the lungs, which allow intra-alveolar communication, may be blocked or poorly developed, resulting in compact and confluent consolidation. Some argue that round pneumonia may represent an early stage of pneumonia when the infection is still contained, nonsegmental, and has smooth borders.…”

Revista Completa 4.1

“…4 (44,44) 3 (33,33) 3 (33,33) 3 (33,33) 2 (22,22) 2 (22,22) 2 (22,22) 1 (11,11) Os fatores de risco para o surgimento da PAV podem ser classificados em modificáveis e não modificáveis. Os considerados como não modificáveis são: idade, escore de gravidade quando da entrada do paciente na UTI e presença de comorbidades.…”

TECHNIKI OBRAZOWANIA Single round shadow of the lung: carcinoma or round pneumonia? – diagnostic problem, differential diagnosis

“…I. Cechy różnicujące zmiany złośliwe i łagodne (na podstawie [11] Pojedynczy cień okrągły w miąższu płucnym: rak płuca czy okrągłe zapalenie płuc? -problem diagnostyczny, różnicowanie płuc [6,7]. Objawami ciężkiej niewydolności oddechowej może manifestować się okrągłe zapalenie płuc w przebiegu zespołu ostrej ciężkiej niewydolności oddechowej (ang.…”