Zhang Ya-Nan, Cao Kexin, Yang Yu, Wei Tong, Li Meng-Jie, Wei Jin-Xia, Liu Qiu-Lian
Department of Respiratory and Critical Care Medicine, Renmin Hospital of Qingxian, Cangzhou, China.
Department of Thoracic Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
Front Med (Lausanne). 2025 Jun 12;12:1578874. doi: 10.3389/fmed.2025.1578874. eCollection 2025.
Invasive mucinous adenocarcinoma (IMA) is a rare malignant tumor of the lung, characterized as a distinct subtype of lung adenocarcinoma, with unique histological features and clinical behavior. Because the diagnosis is often delayed due to its imaging characteristics resembling pneumonia, this neoplasm is associated with a poor prognosis.
This case report describes a 69 years-old man who underwent an asymptomatic health examination, during which small ground-glass opacities were found in the periphery of both lungs. There was no significant change in the lesions during the subsequent 2 years follow-up. However, at the third year of follow-up, the lesions had significantly enlarged. A CT-guided puncture biopsy was performed, and the pathological results indicated IMA of the lung. Subsequently, the patient underwent surgical treatment, and the postoperative pathological findings were consistent with those of the biopsy. In this case, the patient believed that he had been following the doctor's orders for asymptomatic health checks and follow-up reexamination, yet his cancer diagnosis was still significantly delayed. Therefore, the patient demanded that the doctor take medical responsibility for the alleged negligence. After the doctor carefully described the imaging features of lung IMA, the patient ultimately decided to forgo pursuing medical responsibility and expressed satisfaction with the doctor's diagnosis.
This case illustrates the evolving imaging signs of lung IMA. Medical professionals should avoid diagnosing lung cancer as pneumonia, with the aim of enhancing the accuracy of early diagnosis and assisting in clinical evaluation. Additionally, it serves as a reference for patients to better understand this disease.
侵袭性黏液腺癌(IMA)是一种罕见的肺恶性肿瘤,被视为肺腺癌的一种独特亚型,具有独特的组织学特征和临床行为。由于其影像学特征类似肺炎,诊断往往延迟,这种肿瘤预后较差。
本病例报告描述了一名69岁男性,他接受了无症状健康检查,期间在双肺外周发现了小的磨玻璃影。在随后的2年随访中,病变无明显变化。然而,在随访的第三年,病变显著增大。进行了CT引导下穿刺活检,病理结果显示为肺IMA。随后,患者接受了手术治疗,术后病理结果与活检结果一致。在该病例中,患者认为自己一直按照医生的要求进行无症状健康检查和随访复查,但癌症诊断仍被显著延迟。因此,患者要求医生为所谓的疏忽承担医疗责任。在医生仔细描述了肺IMA的影像学特征后,患者最终决定放弃追究医疗责任,并对医生的诊断表示满意。
本病例说明了肺IMA不断演变的影像学征象。医学专业人员应避免将肺癌误诊为肺炎,以提高早期诊断的准确性并辅助临床评估。此外,它为患者更好地了解这种疾病提供了参考。