Unusual presentation of primary lung adenocarcinoma mimicking pneumonia: Case report and literature review

Daoud, Azhar S.; Laktineh, Amir; Zein, Said El; Soubani, Ayman O.

doi:10.1016/j.rmcr.2019.100881

“…The positive rate of EGFR mutation in patients with P-ADC is different from that reported in the literature. For instance, 50 the positive rate of EGFR mutations in P-ADC is reported to be as high as 75% and it is considered that P-ADC is an independent factor predicting the positive mutation of EGFR , and has nothing to do with sex or smoking history.…”

Section: Discussionmentioning

confidence: 99%

Advanced pneumonic type of lung adenocarcinoma: survival predictors and treatment efficacy of the tumor

Zong

¹

,

Zhu

²

,

Wu

³

et al. 2020

Tumori

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Purpose: To retrospectively explore the survival predictors and treatment efficacy of advanced pneumonic-type lung adenocarcinoma (P-ADC). Methods: Retrospective analysis of clinical data and survival follow-up was undertaken on 41 patients with advanced P-ADC from January 1, 2009, to April 30, 2019. Analysis on tumor biomarkers such as carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and the cytokeratin-19-fragment (Cyfra21-1) were undertaken. The patients in this study were divided into three groups based on usage of tyrosine kinase inhibitor (TKI): TKI therapy group (including combination with chemotherapy), non-TKI therapy group (chemotherapy alone), and palliative care group. Results: More than half of the patients had higher levels of tumor biomarkers and the incidence of NSE was highest (81.8%), followed by CEA (74.4%) and Cyfra21-1 (74.1%). All patients had abnormal findings on chest computed tomography and with adenocarcinoma pathology. The overall survival (OS) time was 10.4 months in TKI group, 8.8 months in the non-TKI group, and 2.1 months in the palliative care group. Patients with higher level of serum Cyfra21-1 had insignificantly shorter survival time compared to those with normal Cyfra21-1 ( p = 0.067). TKI therapy and non-TKI therapy provided a better prognosis prediction compared to palliative care. TKI therapy improved prognosis compared to non-TKI therapy. The comprehensive based TKI therapy provided improved OS vs the non-TKI therapy. Conclusion: TKI-based therapy could improve the prognosis and OS for advanced P-ADC. This study recommends the analysis of EGFR mutations for all patients with advanced P-ADC.

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“…In addition, this patient's uncharacteristic non-mucinous adenocarcinoma, is capable of displaying clinical features similar to that of infectious or inflammatory diseases. 11 These deceptive clinical and radiological findings make early recognition and a timely diagnosis of pneumonic type non-mucinous adenocarcinoma challenging. Notable features of this case begin with the initial presentation of the patient with a persistent cough followed by dyspnea, and atypical CT findings.…”

Section: Discussionmentioning

confidence: 99%

Non-mucinous adenocarcinoma: a unique case with a deceptive presentation

Pannozzo¹,

Vyas²,

Letterio³

et al. 2021

JCPCR

0

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Non-mucinous lepidic adenocarcinoma with pneumonic presentation is a rare form of lung cancer. Its ability to mimic infectious and inflammatory diseases in both patient presentation and diagnostic imaging can result in a delayed diagnosis. This case follows the workup of a 60-year-old non-smoker female who immigrated from Ecuador twenty years prior and worked at a shore repair shop for the past two years who presented with worsening shortness of breath and 15lbs weight loss over a two-month period. A unique aspect of this patient's presentation was that the typical imaging and bronchoscopy findings often seen to distinguish this type of lung adenocarcinoma from other disease processes were absent. No nodular masses were observed on Computed Tomography (CT), and no lesions or airway abnormalities were seen on bronchoscopy. It was not until biopsy and bronchoalveolar lavage (BAL) that the diagnosis of adenocarcinoma was recognized. Our case aims to increase awareness among clinicians of the unpredictable presentation of nonmucinous lepidic adenocarcinoma. Furthermore, we want to highlight the relevance of including adenocarcinoma of the lung in the differential diagnosis even when infectious or occupational etiologies appear more likely.

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“…Non-mucinous has been observed in 42% of pneumonic adenocarcinomas, while mucinous is found in 45% with the remaining presentations displaying a mixed histological finding. 11 Therefore, the patient's diagnosis of lepidic non-mucinous adenocarcinoma with a pneumonic presentation is in itself an unusual finding, comprising approximately 1.5% of all lung cancer cases. More importantly, however, this case emphasizes the need to include primary lung adenocarcinomas, specifically the pneumonic type, as a differential diagnosis when clinical findings are suggestive of an infectious or inflammatory disease of the lungs.…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with recent studies comparing pneumonic type adenocarcinoma to infectious pneumonia, peripheral consolidation with surrounding nodules favored the diagnosis of pneumonic-type adenocarcinoma. 11 The lack of any nodular masses in the patient's imaging is a deceptive finding, and resembles an infectious pneumonia. In addition, another distinctive aspect of the patient's presentation was the rapid extension of the cancer to involve both lung fields in three months.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2021

JCPCR

0

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Non-mucinous lepidic adenocarcinoma with pneumonic presentation is a rare form of lung cancer. Its ability to mimic infectious and inflammatory diseases in both patient presentation and diagnostic imaging can result in a delayed diagnosis. This case follows the workup of a 60-year-old non-smoker female who immigrated from Ecuador twenty years prior and worked at a shore repair shop for the past two years who presented with worsening shortness of breath and 15lbs weight loss over a two-month period. A unique aspect of this patient's presentation was that the typical imaging and bronchoscopy findings often seen to distinguish this type of lung adenocarcinoma from other disease processes were absent. No nodular masses were observed on Computed Tomography (CT), and no lesions or airway abnormalities were seen on bronchoscopy. It was not until biopsy and bronchoalveolar lavage (BAL) that the diagnosis of adenocarcinoma was recognized. Our case aims to increase awareness among clinicians of the unpredictable presentation of nonmucinous lepidic adenocarcinoma. Furthermore, we want to highlight the relevance of including adenocarcinoma of the lung in the differential diagnosis even when infectious or occupational etiologies appear more likely.

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Unusual presentation of primary lung adenocarcinoma mimicking pneumonia: Case report and literature review

Cited by 8 publications

References 11 publications

Advanced pneumonic type of lung adenocarcinoma: survival predictors and treatment efficacy of the tumor

Advanced pneumonic type of lung adenocarcinoma: survival predictors and treatment efficacy of the tumor

Non-mucinous adenocarcinoma: a unique case with a deceptive presentation

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