Pulmonary Sarcomatoid Carcinoma Initially Misdiagnosed as Aspergillosis: A Diagnostic Challenge

ABSTRACT Pulmonary sarcomatoid carcinoma (PSC) is a rare and aggressive malignancy that often presents atypically, leading to incomplete diagnosis. We report a 55‐year‐old male with chronic obstructive pulmonary disease who presented with productive cough and haemoptysis. Initial bronchoscopy reveal...

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Main Author: YingYing Qian
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Respirology Case Reports
Subjects:
Online Access:https://doi.org/10.1002/rcr2.70213
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author YingYing Qian
author_facet YingYing Qian
author_sort YingYing Qian
collection DOAJ
description ABSTRACT Pulmonary sarcomatoid carcinoma (PSC) is a rare and aggressive malignancy that often presents atypically, leading to incomplete diagnosis. We report a 55‐year‐old male with chronic obstructive pulmonary disease who presented with productive cough and haemoptysis. Initial bronchoscopy revealed fungal hyphae consistent with Aspergillus infection. The misleading clinical presentation led to an incomplete diagnosis. Subsequent lung biopsy and immunohistochemistry confirmed PSC harbouring an EGFR L858R mutation. Despite the presence of a targetable mutation, the patient showed a poor response to EGFR‐targeted therapy. This case highlights the diagnostic challenges and therapeutic complexities when PSC coexists with an airway fungal infection.
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spelling doaj-art-19fa385b344646b19b3ba2adada9dc602025-08-20T02:30:24ZengWileyRespirology Case Reports2051-33802025-05-01135n/an/a10.1002/rcr2.70213Pulmonary Sarcomatoid Carcinoma Initially Misdiagnosed as Aspergillosis: A Diagnostic ChallengeYingYing Qian0Department of Geriatrics, Second Affiliated Hospital, School of Medicine Zhejiang University Hangzhou ChinaABSTRACT Pulmonary sarcomatoid carcinoma (PSC) is a rare and aggressive malignancy that often presents atypically, leading to incomplete diagnosis. We report a 55‐year‐old male with chronic obstructive pulmonary disease who presented with productive cough and haemoptysis. Initial bronchoscopy revealed fungal hyphae consistent with Aspergillus infection. The misleading clinical presentation led to an incomplete diagnosis. Subsequent lung biopsy and immunohistochemistry confirmed PSC harbouring an EGFR L858R mutation. Despite the presence of a targetable mutation, the patient showed a poor response to EGFR‐targeted therapy. This case highlights the diagnostic challenges and therapeutic complexities when PSC coexists with an airway fungal infection.https://doi.org/10.1002/rcr2.70213aspergillosischemotherapyEGFR mutationmisdiagnosispulmonary sarcomatoid carcinoma
spellingShingle YingYing Qian
Pulmonary Sarcomatoid Carcinoma Initially Misdiagnosed as Aspergillosis: A Diagnostic Challenge
Respirology Case Reports
aspergillosis
chemotherapy
EGFR mutation
misdiagnosis
pulmonary sarcomatoid carcinoma
title Pulmonary Sarcomatoid Carcinoma Initially Misdiagnosed as Aspergillosis: A Diagnostic Challenge
title_full Pulmonary Sarcomatoid Carcinoma Initially Misdiagnosed as Aspergillosis: A Diagnostic Challenge
title_fullStr Pulmonary Sarcomatoid Carcinoma Initially Misdiagnosed as Aspergillosis: A Diagnostic Challenge
title_full_unstemmed Pulmonary Sarcomatoid Carcinoma Initially Misdiagnosed as Aspergillosis: A Diagnostic Challenge
title_short Pulmonary Sarcomatoid Carcinoma Initially Misdiagnosed as Aspergillosis: A Diagnostic Challenge
title_sort pulmonary sarcomatoid carcinoma initially misdiagnosed as aspergillosis a diagnostic challenge
topic aspergillosis
chemotherapy
EGFR mutation
misdiagnosis
pulmonary sarcomatoid carcinoma
url https://doi.org/10.1002/rcr2.70213
work_keys_str_mv AT yingyingqian pulmonarysarcomatoidcarcinomainitiallymisdiagnosedasaspergillosisadiagnosticchallenge