The reason for cavitating lung adenocarcinoma misdiagnosed as pulmonary aspergillus disease

Abstract

Abstract:

Objective To conclude the experience and reduce misdiagnosis rate in future by analyzing a case of single lung cancer cavity misdiagnosed as pulmonary aspergillosis cavity on CT.Methods A patient with lung cancer cavity misdiagnosed as pulmonary aspergillosis was retrospectively analyzed and relevant literatures were reviewed.Results Onset with cough and hemoptysis,a 44-year-old male patient was found with a solitary cavity in the lower lobe of right lung,was misdiagnosed as pulmonary aspergillosis for seven months.The clinical symptoms were improved after antifungal treatment,but there was no obvious change on pulmonary cavity by many times chest CT reexamine.The cavity wall became thicker,the nodules within primary cavity disappeared,and many new tiny wall nodules were found.Serrated protrusions and multiple satellite nodules appeared on the cavity margin and around the cavity respectively.The stretch and connection between cavity and pleura became obvious gradually.Then a definite diagnosis of moderately and poor differentiated lung adenocarcinoma in the lower lobe of right was produced through lung puncture biopsy guided by CT.Conclusion There had certain diffculty to make differential diagnosis of solitary lung cavity by radiographic methods.Clinical characteristics and laboratory tests should be combined to help identification.Tissue pathology was the gold standard for diagnosis.So early biopsy might benecessary to avoid the misdiagnosis and mistreatment,provided that there was no obvious tabooes and risk factors.

Key words: single lung Cavity, differential diagnosis, lung cancer, Pulmonary asperillosis

CLC Number:

ZHU Qiang, CHEN Liang-an, YANG Zhen. The reason for cavitating lung adenocarcinoma misdiagnosed as pulmonary aspergillus disease[J]. Chinese Journal of Mycology, 2016, 11(4): 235-239.

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