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原发性肺腺癌罕见表现为双侧间质性浸润:一例报告及文献复习

A rare presentation of primary lung adenocarcinoma mimicking bilateral interstitial infiltration: A case report and literature review.

作者信息

Abed Renad, Alhroub Wasef, Asbeh Yousef Abu, Rabee Abdelrahman, Bannoura Sami, Madia Arein

机构信息

Faculty of Medicine, Hebron University, Hebron, Palestine.

Faculty of Medicine, Hebron University, Hebron, Palestine.

出版信息

Int J Surg Case Rep. 2025 Feb;127:110899. doi: 10.1016/j.ijscr.2025.110899. Epub 2025 Jan 15.

Abstract

BACKGROUND

Primary lung adenocarcinoma can sometimes present atypically, mimicking interstitial lung disease (ILD), and posing significant diagnostic challenges. Such presentations often lead to misdiagnoses, delaying appropriate treatment.

CASE PRESENTATION

A 35-year-old female non-smoker presented with a six-month history of progressive cough, mild hemoptysis, fatigue, and exertional dyspnea, with no associated weight loss. Imaging studies revealed diffuse ground-glass opacities and interstitial infiltrates, while pulmonary function tests were consistent with interstitial lung disease. Despite these findings, bronchoscopy results were normal. A definitive diagnosis was ultimately made through a biopsy, which identified a moderately to poorly differentiated adenocarcinoma with acinar and micropapillary features.

DISCUSSION

This case highlights the diagnostic complexity when lung adenocarcinoma presents atypically, mimicking ILD. Conventional diagnostic tools, such as imaging and pulmonary function tests, may overlap with ILD findings, leading to misdiagnoses. Early consideration of malignancy and the use of invasive diagnostic procedures, such as biopsy, are essential for distinguishing between ILD and malignancy in atypical cases.

CONCLUSION

This case underscores the importance of maintaining a high index of suspicion for malignancy in atypical ILD presentations. Early invasive diagnostic techniques are crucial for achieving a timely and accurate diagnosis, ultimately improving patient outcomes.

摘要

背景

原发性肺腺癌有时可表现为非典型性,酷似间质性肺疾病(ILD),带来重大诊断挑战。此类表现常导致误诊,延误恰当治疗。

病例报告

一名35岁不吸烟女性,有6个月进行性咳嗽、轻度咯血、乏力及劳力性呼吸困难病史,无体重减轻。影像学检查显示弥漫性磨玻璃影和间质浸润,肺功能检查结果与间质性肺疾病相符。尽管有这些表现,支气管镜检查结果正常。最终通过活检确诊,发现为具有腺泡和微乳头特征的中分化至低分化腺癌。

讨论

该病例凸显了肺腺癌非典型表现酷似ILD时的诊断复杂性。传统诊断工具,如图像检查和肺功能检查,可能与ILD表现重叠,导致误诊。在非典型病例中,早期考虑恶性肿瘤并采用活检等侵入性诊断程序对于区分ILD和恶性肿瘤至关重要。

结论

该病例强调了对非典型ILD表现保持高度恶性肿瘤怀疑指数的重要性。早期侵入性诊断技术对于及时准确诊断至关重要,最终可改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3c3/11786693/988b70b7c098/gr1.jpg

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