侵袭性黏液腺癌是一种多中心腺癌,占所有肺癌诊断的不到5%。最常见的症状(咳嗽,痰液生产,和胸痛)结合其影像学表现(斑驳,多叶浸润)使浸润性粘液腺癌难以区分感染性肺炎和炎症性肺炎。然而,由于其侵略性,如果假定的肺炎病例缺乏感染症状,应考虑浸润性黏液腺癌(例如,发烧,白细胞增多)和/或对抗生素无反应。我们报告了一例75岁的男性,他在假定的复发性肺炎病例中入院。对之前的抗生素治疗没有反应。进一步的工作,包括经支气管活检,证实为粘液性腺癌,呈粘液性腺癌。此案例强调了在适当的抗生素覆盖后,在未解决的肺炎中建立广泛差异的重要性。
Invasive mucinous adenocarcinoma is a multi-centric adenocarcinoma that accounts for less than 5% of all lung cancer diagnoses. The most common presenting symptoms (cough, sputum production, and chest pain) in conjunction with its radiographic findings (patchy, multi-lobar infiltrates) make invasive mucinous adenocarcinoma challenging to distinguish from both infectious and inflammatory pneumonia. However, due to its aggressive nature, invasive mucinous adenocarcinoma should be considered if a presumed
case of pneumonia lacks symptoms of infection (e.g., fever, leukocytosis) and/or does not respond to antibiotics. We report the
case of a 75-year-old male who was admitted in the setting of a presumed
case of recurrent pneumonia, which had failed to respond to prior antibiotic therapy. Further workup, including trans-bronchial biopsy, confirmed mucinous adenocarcinoma with a lepidic pattern. This
case highlights the importance of establishing a broad differential in the setting of unresolved pneumonia following appropriate antibiotic coverage.