Maule Geran, Alqudah Qusai, Ismail Mohamed, Fox Ryan, Gill Ajaypal, Javier Luis
Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, Florida, USA.
Department of Graduate Medical Education, HCA Florida North Florida Hospital, Gainesville, Florida, USA.
Case Rep Pulmonol. 2025 Jun 9;2025:6678388. doi: 10.1155/crpu/6678388. eCollection 2025.
A 52-year-old female with a history of gastroesophageal reflux disease (GERD), hypertension (HTN), and supraventricular tachycardia (SVT) status postablation presented with progressive dyspnea and diffuse bilateral infiltrates on imaging. Symptoms began following exposure to a chicken farm, initially as a dry cough, evolving despite treatment with antibiotics, albuterol, and methylprednisolone. Emergency department CT imaging demonstrated bilateral linear, reticular, and nodular infiltrates. A negative infectious workup prompted bronchoscopy, confirming lung adenocarcinoma via immunohistochemical staining despite no significant smoking history, international travel, or other exposures. Brain MRI identified a solitary 7-mm enhancing lesion, guiding subsequent oncologic management. This case underscores the complexity of diagnosing atypical pulmonary symptoms and advocates for early bronchoscopic evaluation in suspected malignancies, particularly with pertinent family history.
一名52岁女性，有胃食管反流病（GERD）、高血压（HTN）和室上性心动过速（SVT）消融术后病史，出现进行性呼吸困难，影像学检查显示双侧弥漫性浸润。症状始于接触养鸡场后，最初为干咳，尽管使用了抗生素、沙丁胺醇和甲泼尼龙治疗仍有进展。急诊科CT成像显示双侧线性、网状和结节状浸润。阴性的感染性检查结果促使进行支气管镜检查，尽管没有明显的吸烟史、国际旅行史或其他接触史，但通过免疫组织化学染色确诊为肺腺癌。脑部MRI发现一个7毫米的孤立强化病灶，为后续的肿瘤治疗提供了指导。该病例强调了诊断非典型肺部症状的复杂性，并提倡对疑似恶性肿瘤进行早期支气管镜评估，尤其是有相关家族史的情况。
