Approach to Multiple Pulmonary Nodules: A Case Report and Review of Literature
Chest X-ray and CT examinations often find pulmonary nodules that could be malignant or benign. A case is presented and discussed here in order to improve diagnosis and management of pulmonary nodules. A 62-year-old lady was found to have multiple pulmonary nodules by X-ray when she complained of a...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1100/tsw.2011.74 |
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| _version_ | 1849695435765055488 |
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| author | Farshid Niknam Jiezhong Chen Sabar Napaki Morteza Aghmesheh |
| author_facet | Farshid Niknam Jiezhong Chen Sabar Napaki Morteza Aghmesheh |
| author_sort | Farshid Niknam |
| collection | DOAJ |
| description | Chest X-ray and CT examinations often find pulmonary nodules that could be malignant or benign. A case is presented and discussed here in order to improve diagnosis and management of pulmonary nodules. A 62-year-old lady was found to have multiple pulmonary nodules by X-ray when she complained of a cough and fever. This was confirmed by a CT scan. Fine needle aspiration (FNA) of one of the lung lesions reported scant atypical epithelial cells that stained positive for TTF-1 and cytokeratin 7, but negative for cytokeratin 20. Thus, it was suspicious for large cell carcinoma. A videothoracoscopic lung biopsy and histopathology were applied and showed a necrotic nodule with surrounding chronic inflammation and macrophage response, with no evidence of malignant cells. Atypical reactive pneumocytes at the periphery of the lesion (an old infarct) were probably equivalent to the atypical cells seen on cytology. This result changed the diagnosis of our patient from a malignant condition to a benign process. Thus, CT and FNA may give a false positive. A second pathological opinion is very useful for the right diagnosis and management, as shown in our case. |
| format | Article |
| id | doaj-art-cff92effca3040b09a6d993ab3477e20 |
| institution | DOAJ |
| issn | 1537-744X |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-cff92effca3040b09a6d993ab3477e202025-08-20T03:19:46ZengWileyThe Scientific World Journal1537-744X2011-01-011176076510.1100/tsw.2011.74Approach to Multiple Pulmonary Nodules: A Case Report and Review of LiteratureFarshid Niknam0Jiezhong Chen1Sabar Napaki2Morteza Aghmesheh3Wollongong Hospital, Wollongong, NSW, AustraliaIllawarra Health and Medical Research Institute, University of Wollongong, Wollongong, AustraliaWollongong Hospital, Wollongong, NSW, AustraliaIllawara Cancer Care Centre, Wollongong Hospital, Wollongong, NSW, AustraliaChest X-ray and CT examinations often find pulmonary nodules that could be malignant or benign. A case is presented and discussed here in order to improve diagnosis and management of pulmonary nodules. A 62-year-old lady was found to have multiple pulmonary nodules by X-ray when she complained of a cough and fever. This was confirmed by a CT scan. Fine needle aspiration (FNA) of one of the lung lesions reported scant atypical epithelial cells that stained positive for TTF-1 and cytokeratin 7, but negative for cytokeratin 20. Thus, it was suspicious for large cell carcinoma. A videothoracoscopic lung biopsy and histopathology were applied and showed a necrotic nodule with surrounding chronic inflammation and macrophage response, with no evidence of malignant cells. Atypical reactive pneumocytes at the periphery of the lesion (an old infarct) were probably equivalent to the atypical cells seen on cytology. This result changed the diagnosis of our patient from a malignant condition to a benign process. Thus, CT and FNA may give a false positive. A second pathological opinion is very useful for the right diagnosis and management, as shown in our case.http://dx.doi.org/10.1100/tsw.2011.74 |
| spellingShingle | Farshid Niknam Jiezhong Chen Sabar Napaki Morteza Aghmesheh Approach to Multiple Pulmonary Nodules: A Case Report and Review of Literature The Scientific World Journal |
| title | Approach to Multiple Pulmonary Nodules: A Case Report and Review of Literature |
| title_full | Approach to Multiple Pulmonary Nodules: A Case Report and Review of Literature |
| title_fullStr | Approach to Multiple Pulmonary Nodules: A Case Report and Review of Literature |
| title_full_unstemmed | Approach to Multiple Pulmonary Nodules: A Case Report and Review of Literature |
| title_short | Approach to Multiple Pulmonary Nodules: A Case Report and Review of Literature |
| title_sort | approach to multiple pulmonary nodules a case report and review of literature |
| url | http://dx.doi.org/10.1100/tsw.2011.74 |
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