Rentas Courtney M, Goetz Ryan, Mkorombindo Takudzwa, Bajaj Sanjiv, Centor Robert
Department of Medicine, The University of Alabama School of Medicine, Birmingham, USA.
Department of Radiology, Birmingham Veterans Affairs Medical Center, Birmingham, USA.
Cureus. 2020 Oct 22;12(10):e11088. doi: 10.7759/cureus.11088.
Invasive mucinous adenocarcinoma is a multi-centric adenocarcinoma that accounts for less than 5% of all lung cancer diagnoses. The most common presenting symptoms (cough, sputum production, and chest pain) in conjunction with its radiographic findings (patchy, multi-lobar infiltrates) make invasive mucinous adenocarcinoma challenging to distinguish from both infectious and inflammatory pneumonia. However, due to its aggressive nature, invasive mucinous adenocarcinoma should be considered if a presumed case of pneumonia lacks symptoms of infection (e.g., fever, leukocytosis) and/or does not respond to antibiotics. We report the case of a 75-year-old male who was admitted in the setting of a presumed case of recurrent pneumonia, which had failed to respond to prior antibiotic therapy. Further workup, including trans-bronchial biopsy, confirmed mucinous adenocarcinoma with a lepidic pattern. This case highlights the importance of establishing a broad differential in the setting of unresolved pneumonia following appropriate antibiotic coverage.
浸润性黏液腺癌是一种多中心腺癌，占所有肺癌诊断病例的不到5%。其最常见的症状（咳嗽、咳痰和胸痛）及其影像学表现（斑片状、多叶浸润）使得浸润性黏液腺癌难以与感染性肺炎和炎症性肺炎相区分。然而，由于其侵袭性，对于疑似肺炎病例，如果缺乏感染症状（如发热、白细胞增多）和/或对抗生素无反应，则应考虑浸润性黏液腺癌。我们报告一例75岁男性病例，该患者因疑似复发性肺炎入院，先前的抗生素治疗无效。进一步检查，包括经支气管活检，确诊为具有鳞屑样模式的黏液腺癌。该病例强调了在适当的抗生素治疗后，对于未解决的肺炎建立广泛鉴别诊断的重要性。
