Yang Yuping, Huang Rongfei, Xiang Liping, Zeng Jun, Zhao Wei, Huang Na
Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China.
Department of Pathology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China.
Exp Ther Med. 2023 Feb 28;25(4):168. doi: 10.3892/etm.2023.11867. eCollection 2023 Apr.
Common imaging findings of invasive mucinous adenocarcinoma (IMA) include consolidation of the lung parenchyma, nodules, and ground-glass changes. However, the IMA imaging findings in the present case included diffuse, patchy and blurry density shadows through both lungs. To the best of the authors' knowledge, this image pattern has rarely been reported. The patient provided his consent and authorized the publication of photographs featuring his likeness. The present study reported a patient was diagnosed with IMA via pathologic and genetic analyses. Following antibiotic treatment, the lesions in both sides became larger. Further examinations were completed and IMA was confirmed by biopsy pathohistological examination. Pathological specimens were negative for almost all driver genes mutations, except KRAS. The patients and family refused further treatment, including chemotherapy, radiotherapy and interventional chemotherapy and the patient was discharged from The First Affiliated Hospital of Chengdu Medical College. The present case report emphasized that IMA should be suspected when imaging studies show diffuse lesions throughout both lungs. When a patient does not respond to treatment, clinicians should consider alternative diagnoses.
浸润性黏液腺癌(IMA)的常见影像学表现包括肺实质实变、结节和磨玻璃样改变。然而,本例IMA的影像学表现为双肺弥漫性、斑片状及模糊的密度影。据作者所知,这种影像表现鲜有报道。患者已签署知情同意书并授权发表其照片。本研究报告了1例经病理及基因分析确诊为IMA的患者。抗生素治疗后,双侧病变增大。进一步检查后,活检病理组织学检查确诊为IMA。除KRAS外,病理标本几乎所有驱动基因突变均为阴性。患者及其家属拒绝进一步治疗,包括化疗、放疗及介入化疗,患者从成都医学院第一附属医院出院。本病例报告强调,当影像学检查显示双肺弥漫性病变时,应怀疑IMA。当患者对治疗无反应时,临床医生应考虑其他诊断。