COVID-19 pneumonia presenting as a single pulmonary nodule in a kidney transplant recipient: A case report and literature review

Rasekhi, Alireza; Hoseinyazdi, Meisam; Esmaeilian, Saeid; Teimouri, Arash; Safaei, Akbar; Rafiee, Faranak

doi:10.1016/j.radcr.2020.06.054

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…For example, a recent case reports a concurrent solid nodule in a 37-year-old COVID-19 pneumonia patient who was also a renal transplant recipient. The nodule eventually on biopsy turned out to be an adenocarcinoma lung [14]. A similar case report in a healthy 40-year-old male also led to the diagnosis of adenocarcinoma in a patient with COVID-19 infection who presented with multiple bilateral round to elliptical peripheral ground-glass opacities initially attributed to COVID-19 pneumonia and later on biopsy confirmed to be adenocarcinoma of the lung [15].…”

Section: Discussionmentioning

confidence: 67%

Sarcoidosis Presenting as a Lung Mass in a Patient With COVID-19 Infection: A Case Report

Pokhriyal,

Nabeel Pasha,

Khan

et al. 2023

Cureus

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Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is known to be associated with immune dysregulation and can cause multiorgan dysfunction. Sarcoidosis is another disease associated with increased inflammatory responses due to immune dysregulation which can also affect multiple organs. Although sarcoidosis, like COVID-19 infection, can affect virtually any organ, the lungs are the most commonly affected organs. Sarcoidosis most commonly presents as lung nodules and bilateral hilar lymphadenopathy. Rarely, multiple granulomatous lesions can coalesce and manifest as lung masses, and these often mimic lung cancer. We present a case of a 64-year-old male who presented with shortness of breath and pneumonia-like symptoms for one week and a nasopharyngeal swab for SARS-CoV-2 was positive. Workup revealed a large 6.3×4.7 cm lung mass in the right upper lobe along with enlarged bilateral lymph nodes. A CT-guided lung biopsy was done which revealed non-caseating granulomas containing epithelioid cells. Other causes of granuloma like tuberculosis and fungal infections were ruled out. The patient was managed with low-dose steroids and a follow-up CT scan done after eight months revealed complete resolution of lung mass with minimal mediastinal lymphadenopathy. This is, as far as we are aware, the first case of COVID-19 infection manifesting as a lung mass that was ultimately diagnosed as sarcoidosis.

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Section: Discussionmentioning

confidence: 67%

Sarcoidosis Presenting as a Lung Mass in a Patient With COVID-19 Infection: A Case Report

Pokhriyal,

Nabeel Pasha,

Khan

et al. 2023

Cureus

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“…Prior to the advent and widespread adoption of polymerase chain reaction (PCR) assays for the diagnosis of COVID-19, lung computed tomography (CT) scans served as the primary diagnostic modality, particularly in Iran (13). As a result of the pronounced ionization effect associated with CT scans, the majority of pregnant patients exhibiting minor symptoms were not subjected to this imaging technique.…”

Section: Discussionmentioning

confidence: 99%

Do chest CT findings predict the outcome in pregnant patients with COVID-19 pneumonia? A cross-sectional study

Esmaeilian,

Teimouri,

Hoseinyazdi

et al. 2024

Preprint

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Background: COVID-19 is a novel infectious disease that poses significant challenges for the management of pregnant patients, especially regarding the use and interpretation of chest CT scans. This study aimed to evaluate the clinical significance and radiological features of chest CT scans in pregnant women with COVID-19. Methods: The authors conducted a cross-sectional, multi-center study of 53 pregnant women with confirmed COVID-19 by RT-PCR testing who underwent chest CT scans in three hospitals in Iran. They collected and analyzed data on demographic, clinical, laboratory, and radiological variables, as well as maternal and neonatal outcomes. They used low-dose chest CT protocol and abdominal shields to minimize radiation exposure and assessed the interobserver reliability of the chest CT diagnosis using Cohen’s kappa coefficient. Results: The study included 41 pregnant women with COVID-19 and available chest CT scans. The mean maternal age was 34.6±7.60 years and the mean gestational age was 28.73±5.66 weeks. Dyspnea was the most common symptom (85.4%), followed by fever (68.3%) and cough (51.2%). Asthma (p=0.001) and diabetes (p=0.001) were significantly associated with worse outcomes and abnormal chest CT scans. Myalgia (p=0.001), respiratory distress (p=0.001), admission O2 saturation (p=0.001), leukopenia (p=0.001), lymphocytosis (p=0.001), and high CRP levels (p=0.001) were also correlated with adverse outcomes and abnormal chest CT scans. Normal chest scans were observed in 25 patients (61%), while 16 patients (39%) had abnormal CT scan findings. Ground glass opacity (81.3%) and consolidation (68.8%) were the most common radiological features on chest CT scans. Four maternal deaths occurred due to delayed referral and underlying comorbidities such as heart failure or renal failure. Conclusion: The percentage of lung involvement and the presence of consolidation on chest CT scans could predict the prognosis of pregnant women with COVID-19. Chest CT scans could be a useful tool for the diagnosis and management of COVID-19 in pregnancy, especially in cases of severe symptoms or comorbidities.

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“…Radiological findings are used to determine the stage and severity of COVID-19 pneumonia. Asymptomatic individuals can present with unique, isolated, peripheral lesions [4][5][6] , and although isolated nodules are common in viral pneumonia, several cases have been reported where small, solitary pulmonary nodules appear as the initial presentation of COVID-19 pneumonia [8][9][10] . The opposite can also occur, however.…”

Section: Discussionmentioning

confidence: 99%

Delayed Diagnosis of an Atypical Pneumonia Resembling a Solitary Pulmonary Nodule

García-Carretero¹,

Vázquez-Gómez²,

Rodriguez-Maya³

et al. 2021

Cureus

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Atypical pneumonia shows clinical features that are different from those of typical pneumonia, and it can mimic other entities. We report the case of a 42-year-old male with a solitary pulmonary nodule found in an X-ray for a preoperative evaluation. Our patient was asymptomatic, and a pulmonary neoplasm was the first diagnostic suspicion. The round-shaped nodule seen in the X-ray turned out to be a linear ground glass opacity in a thoracic CT scan. Viral pneumonia due to SARS-CoV-2 was diagnosed. We emphasize here the educational value of this case report. We do not report a new radiological finding because lung nodules resembling neoplasms have already been reported in the medical literature. However, some clinical features of COVID-19 are relatively new and can mimic other entities, and the results of some investigations and clinicians’ interpretations of them can be misleading. Atypical radiological findings make it necessary to widen the spectrum of alternative diagnoses.

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COVID-19 pneumonia presenting as a single pulmonary nodule in a kidney transplant recipient: A case report and literature review

Cited by 5 publications

References 27 publications

Sarcoidosis Presenting as a Lung Mass in a Patient With COVID-19 Infection: A Case Report

Sarcoidosis Presenting as a Lung Mass in a Patient With COVID-19 Infection: A Case Report

Do chest CT findings predict the outcome in pregnant patients with COVID-19 pneumonia? A cross-sectional study

Delayed Diagnosis of an Atypical Pneumonia Resembling a Solitary Pulmonary Nodule

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