Qian YingYing
Department of Geriatrics, Second Affiliated Hospital, School of Medicine Zhejiang University Hangzhou China.
Respirol Case Rep. 2025 May 19;13(5):e70213. doi: 10.1002/rcr2.70213. eCollection 2025 May.
Pulmonary sarcomatoid carcinoma (PSC) is a rare and aggressive malignancy that often presents atypically, leading to incomplete diagnosis. We report a 55-year-old male with chronic obstructive pulmonary disease who presented with productive cough and haemoptysis. Initial bronchoscopy revealed fungal hyphae consistent with Aspergillus infection. The misleading clinical presentation led to an incomplete diagnosis. Subsequent lung biopsy and immunohistochemistry confirmed PSC harbouring an EGFR L858R mutation. Despite the presence of a targetable mutation, the patient showed a poor response to EGFR-targeted therapy. This case highlights the diagnostic challenges and therapeutic complexities when PSC coexists with an airway fungal infection.
肺肉瘤样癌（PSC）是一种罕见且侵袭性强的恶性肿瘤，通常表现不典型，导致诊断不完整。我们报告一例55岁患有慢性阻塞性肺疾病的男性，表现为咳痰和咯血。最初的支气管镜检查发现符合曲霉菌感染的真菌菌丝。这种具有误导性的临床表现导致诊断不完整。随后的肺活检和免疫组化证实为携带表皮生长因子受体（EGFR）L858R突变的PSC。尽管存在可靶向的突变，但该患者对EGFR靶向治疗反应不佳。该病例突出了PSC与气道真菌感染共存时的诊断挑战和治疗复杂性。
