Faculty of Medicine, Palestine Polytechnic University, Hebron, State of Palestine.
Faculty of Medicine, Al Quds University, Jerusalem, Palestine.
Medicine (Baltimore). 2024 Aug 2;103(31):e39189. doi: 10.1097/MD.0000000000039189.
Lung adenocarcinoma may resemble the clinical presentation of an infectious or inflammatory lung disease. The coexistence of lung cancer, and polyserous effusions is uncommon, which may cause a diagnostic challenge. However, any polyserous effusions at a young age must always be suspicious for malignancy.
We report a case of 38-year-old male patient with polyserous effusions and pneumonia who was treated accordingly and showed clinical improvement with a significant reduction of pericardial and pleural effusions. Subsequent testing and a biopsy resulted in the histopathological diagnosis of an adenocarcinoma of the lung.
Nonrecurrent polyserous effusions in lung adenocarcinoma are uncommon, and negative cytology results may not exclude malignancy due to the moderate sensitivity of pleural and pericardial fluid cytology. Clinicians should remain vigilant for false-negative results, especially in younger patients. Malignancy should not be ruled out because pleural and pericardial fluid cytology have a sensitivity of 60% and 92%, respectively.
Our case highlights the diagnostic challenges posed by atypical presentations of lung adenocarcinoma and emphasizes the importance of considering malignancy in the differential diagnosis of polyserous effusions, even when initial cytology results are negative. Clarifying the rationale for this study enhances its relevance and impact.
肺腺癌可能类似于感染或炎症性肺部疾病的临床表现。肺癌和多浆膜腔积液并存并不常见，这可能会导致诊断上的挑战。然而，任何年轻患者的多浆膜腔积液都必须始终怀疑为恶性肿瘤。
我们报告了一例 38 岁男性患者，他患有多浆膜腔积液和肺炎，根据临床表现进行了相应治疗，心包和胸腔积液明显减少，患者的临床症状得到改善。进一步的检查和活检结果为肺腺癌的组织病理学诊断。
非复发性肺腺癌多浆膜腔积液并不常见，由于胸腔和心包积液细胞学检查的中度敏感性，阴性细胞学结果不能排除恶性肿瘤。临床医生应警惕假阴性结果，尤其是在年轻患者中。不能因为胸腔和心包积液细胞学检查的敏感性分别为 60%和 92%而排除恶性肿瘤。
我们的病例强调了肺腺癌不典型表现所带来的诊断挑战，并强调了在多浆膜腔积液的鉴别诊断中即使初始细胞学结果为阴性也要考虑恶性肿瘤的重要性。阐明本研究的基本原理增强了其相关性和影响力。
