Department of Respiratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo 181-8611, JapanJapan
Department of Pathology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka
Department of General Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Article History Mitaka City, Tokyo, 181-8611, JapanJapan
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A 68-year-old man was transferred to our hospital because of abnormal lung nodule. He was a social drinker and a current smoker with a history of 70 pack-years. He had no symp-toms and was a good nutritional status. Based on the pulmonary function tests, he was diag-nosed with chronic obstructive lung disease stage II by Global Initiative on Obstructive Lung Disease staging system. Pulmonary aspergillosis; Mimicking lung cancer; Thoracic CT.
Keywords: Pulmonary aspergillosis; Mimicking lung cancer; Thoracic CT
PULMONARY RESEARCH AND RESPIRATORY MEDICINE ISSN 2377-1658 http://dx.doi.org/10.17140/PRRMOJ-2-111 Open Journal Illustration Pulmonary Aspergillosis Mimicking Primary * *Corresponding author Lung Cancer Takeshi Saraya, MD, PhD Department of Respiratory Medicine Kyorin University School of Medicine 6-20-2 Shinkawa, Mitaka City 1* 1 2 1 Takeshi Saraya , Takeshi Nosaka , Masachika Fujiwara , Hiroki Nunokawa , Kosuke Oh- Tokyo 181-8611, Japan 1 1 3 3 1 kuma , Naoki Tsujimoto , Shin Karita , Haruhiko Kondo and Hajime Takizawa Tel. +81 (0)422 44 0671 Fax: +81 (0)422 44 0671 E-mail: sara@yd5.so-net.ne.jp 1Department of Respiratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo 181-8611, Japan Volume 2 : Issue 2 2 Department of Pathology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka Article Ref. #: 1000PRRMOJ2111 City, Tokyo 181-8611, Japan 3Department of General Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Article History Mitaka City, Tokyo, 181-8611, Japan th Received: March 29th, 2015 th Accepted: April 14th, 2015 th Published: April 14th, 2015 KEYWORDS: Pulmonary aspergillosis; Mimicking lung cancer; Thoracic CT. Citation A 68-year-old man was transferred to our hospital because of abnormal lung nodule. Saraya T, Nosaka T, Fujiwara M, et He was a social drinker and a current smoker with a history of 70 pack-years. He had no symp- al. Pulmonary aspergillosis mimick- toms and was a good nutritional status. Based on the pulmonary function tests, he was diag- ing primary lung cancer. Pulm Res nosed with chronic obstructive lung disease stage II by Global Initiative on Obstructive Lung Respir Med Open J. 2015; 2(2): 75- 76. doi: 10.17140/PRRMOJ-2-111 Disease staging system. Thoracic Computed Tomography (CT) showed the irregular-shaped nodule measuring 15 mm in size with spiculation at right S1 (Figure A), which accompanied by emphysematous lung changes. On thoracic FDG PET/CT, the nodule demonstrated the intense standardized uptake values both in the early (max 3.4) and delayed (max 4.2) phases, suggest- ing malignancy (Figure B). However, video-assisted thoracic surgery biopsied specimens on Hematoxylin and eosin stains showed that the nodule was consisted of central necrotic compo- nent surrounded by microabscesses and fibrotic granulomatous tissues (Figure C) in which con- tained filamentous fungi on Grocott’s methenamine silver stain (Figure D) with calcium oxalate crystal deposition, indicating of pulmonary aspergillosis. Pulmonary aspergillosismimicking 1-2 cancer was an extremely rare event,1-2 but should be included in the differential diagnosis for solitary pulmonary nodule.
Copyright ©2015 Saraya T. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
PULMONARY RESEARCH AND RESPIRATORY MEDICINE ISSN 2377-1658 http://dx.doi.org/10.17140/PRRMOJ-2-111 Open Journal CONFLICTS OF INTEREST The authors have no conflicts of interest to declare.
CONSENT Written informed consent was obtained from the patient for pub- lication of this case report and any accompanying images.