Interstitial lung disease pattern turned out to be a predominantly lepidic lung adenocarcinoma

Abstract

We report a case of a 46-year-old woman without any medical history who presented to our Respiratory Department with exertional dyspnoea for the last 6 weeks associated with non-productive cough. Chest radiography showed bilateral diffuse interstitial opacity. Bronchoalveolar lavage and transbronchial biopsies performed during flexible bronchoscopy as a step in the diagnostic workup of idiopathic interstitial pneumonia showed cells of pulmonary adenocarcinoma.

Interstitial lung disease was suspected, but biopsy revealed pulmonary lymphangitis carcinomatosa

“…In a case report by Irena Hammen, she presents diagnostic consideration of diffuse interstitial lung disease in a case regarding a 46-year-old woman with exertional dyspnoea, non-productive cough, and HRCT showing ground-glass opacities and interlobular septal thickening. Idiopathic interstitial pneumonia was suspected, but transbronchial lung biopsy revealed lepidic lung adenocarcinoma and PLC [ 7 ].…”

Hypertrophic osteoarthropathy mimicking a reactive arthritis: a case report and review of the literature

“…Given that in our patient HOA was associated with worsening of digital clubbing and a chest infiltrate, a bronchoscopy was performed, showing a lepidic predominant lung adenocarcinoma, which was then confirmed by the autopsy. It has been shown that diagnosis of lepidic predominant lung adenocarcinoma (formerly known as non-mucinous bronchoalveolar lung cancer) [ 9 ] is sometimes quite challenging because it can exhibit radiological features suggestive of interstitial lung disease [ 10 ] or it can mimic a recurrent bacterial community acquired pneumonia [ 11 ]. In line with these reports, our case highlights that radiological evidence of interstitial lung disease or pneumonia does not rule out a pulmonary malignancy, but warrants further investigations in patients with a high clinical suspicion of lung cancer, such as in the case of HOA.…”