Arwi Gerardo, Fogarty Paul, Mant Andrew, H'ng Julee, Barling Andrew, Thien Francis
Department of Lung and Sleep, Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
Department of Respiratory and Sleep Medicine, Eastern Health, 8 Arnold St, Box Hill, VIC, 3128, Australia.
J Med Case Rep. 2025 Jun 10;19(1):269. doi: 10.1186/s13256-025-05140-2.
The diagnostic evaluation of complex cavitary lung lesions is often challenging owing to the broad spectrum of differential diagnoses. These lesions can be associated with various conditions, making it crucial to employ comprehensive diagnostic strategies. This case underscores the significance of serial imaging, close clinical follow-up, and surgical biopsy in managing such complex cases.
A 59-year-old woman of Indian descent was referred for the management of pneumonia. Initial chest computed tomography showed patchy inflammatory changes in the right upper lobe, a large cavity in the left upper lobe, and a smaller cavity in the left lower lobe. Follow-up imaging indicated progressive cavitary disease. Bronchoscopies did not yield significant findings. A video-assisted thoracoscopic surgery biopsy was performed, which confirmed mucinous adenocarcinoma.
This case highlights the diagnostic challenge posed by cavitary lung lesions and emphasizes the importance of serial imaging, vigilant clinical monitoring, and surgical biopsy in achieving an accurate diagnosis. Early and systematic investigation is key to identifying rare causes such as mucinous adenocarcinoma.
由于鉴别诊断范围广泛,复杂空洞性肺病变的诊断评估往往具有挑战性。这些病变可能与多种情况相关,因此采用全面的诊断策略至关重要。本病例强调了系列影像学检查、密切的临床随访以及手术活检在处理此类复杂病例中的重要性。
一名59岁的印度裔女性因肺炎前来就诊。最初的胸部计算机断层扫描显示右上叶有斑片状炎症改变,左上叶有一个大空洞,左下叶有一个较小的空洞。随访影像学检查显示空洞性疾病进展。支气管镜检查未发现明显异常。进行了电视辅助胸腔镜手术活检,确诊为黏液腺癌。
本病例突出了空洞性肺病变带来的诊断挑战,并强调了系列影像学检查、警惕的临床监测以及手术活检对于准确诊断的重要性。早期和系统的调查是识别黏液腺癌等罕见病因的关键。