Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2020

01-12-2020 | Computed Tomography | Case report

Lung carcinoma with diffuse cystic lesions misdiagnosed as pulmonary langerhans cell histocytosis: a case report

Authors: Xianhua Gui, Jingjing Ding, Yan Li, Min Yu, Tingting Chen, Mei Huang, Yonglong Xiao

Published in: BMC Pulmonary Medicine | Issue 1/2020

Login to get access

Abstract

Background

Cystic airspace is an uncommon imaging manifestation involved in non-small lung cancer (NSCLC). Diffuse cystic lesion is even rarer as pulmonary manifestation of NSCLC. In the present study, we reported a rare case of NSCLC associated with progressive diffusion of cystic lesions misdiagnosed as Pulmonary langerhans cell histocytosis (PLCH), finally diagnosed by transbronchial cryobiopsy (TBCB).

Case presentation

A 52-year-old woman was admitted to our hospital due to cough and dyspnea. High-resolution computed tomography (HRCT) presented diffuse cystic shadow mostly, concomitantly with nodular densities in bilateral lungs. A lung biopsy revealed poorly differentiated adenocarcinoma with vascular tumor emboli. The epidermal growth factor receptor (EGFR) mutation on exon 18 (G719X, G719) was detected by mutation test. The patient received treatment of tyrosine kinase inhibitor (afatinib).

Conclusions

Diffuse cystic lesion can be a rare manifestation of lung cancer. It was important to improve the recognition of diffuse cystic lung diseases to avoid misdiagnosis.
Literature
1.
go back to reference Gupta N, Vassallo R, Wikenheiser-Brokamp KA, et al. Diffuse cystic lung disease. Part I. Am J Respir Crit Care Med. 2015;191(12):1354–66.CrossRef Gupta N, Vassallo R, Wikenheiser-Brokamp KA, et al. Diffuse cystic lung disease. Part I. Am J Respir Crit Care Med. 2015;191(12):1354–66.CrossRef
2.
go back to reference Stern E, Huseini T, Kuok Y, et al. Metastatic pancreatic carcinoma masquerading as cystic lung disease: a rare presentation. Respirology case reports. 2017;5(5):e00246.CrossRef Stern E, Huseini T, Kuok Y, et al. Metastatic pancreatic carcinoma masquerading as cystic lung disease: a rare presentation. Respirology case reports. 2017;5(5):e00246.CrossRef
3.
go back to reference Fielli M, Avila F, Saino A, Seimah D, et al. Diffuse cystic lung disease due to pulmonary metastasis of colorectal carcinoma. Respir Med Case Rep. 2016;17:83–5.PubMedPubMedCentral Fielli M, Avila F, Saino A, Seimah D, et al. Diffuse cystic lung disease due to pulmonary metastasis of colorectal carcinoma. Respir Med Case Rep. 2016;17:83–5.PubMedPubMedCentral
4.
go back to reference Hasegawa S, Inui K, Kamakari K, et al. Pulmonary cysts as the sole metastatic manifestation of soft tissue sarcoma: case report and consideration of the pathogenesis. Chest. 1999;116(1):263–5.CrossRef Hasegawa S, Inui K, Kamakari K, et al. Pulmonary cysts as the sole metastatic manifestation of soft tissue sarcoma: case report and consideration of the pathogenesis. Chest. 1999;116(1):263–5.CrossRef
5.
go back to reference Hoag JB, Sherman M, Fasihuddin Q, et al. A comprehensive review of spontaneous pneumothorax complicating sarcoma. Chest. 2010;138(3):510–8.CrossRef Hoag JB, Sherman M, Fasihuddin Q, et al. A comprehensive review of spontaneous pneumothorax complicating sarcoma. Chest. 2010;138(3):510–8.CrossRef
6.
go back to reference Gupta N, Vassallo R, Wikenheiser-Brokamp KA, et al. Diffuse cystic lung disease. Part II. Am J Respir Crit Care Med. 2015;192(1):17–29.CrossRef Gupta N, Vassallo R, Wikenheiser-Brokamp KA, et al. Diffuse cystic lung disease. Part II. Am J Respir Crit Care Med. 2015;192(1):17–29.CrossRef
7.
go back to reference Mascalchi M, Attina D, Bertelli E, et al. Lung cancer associated with cystic airspaces. J Comput Assist Tomogr. 2015;39(1):102–8.CrossRef Mascalchi M, Attina D, Bertelli E, et al. Lung cancer associated with cystic airspaces. J Comput Assist Tomogr. 2015;39(1):102–8.CrossRef
8.
go back to reference Zhang J, Zhao YL, Ye MX, et al. Rapidly progressive diffuse cystic lesions as a radiological hallmark of lung adenocarcinoma. J Thorac Oncol. 2012;7(2):457–8.CrossRef Zhang J, Zhao YL, Ye MX, et al. Rapidly progressive diffuse cystic lesions as a radiological hallmark of lung adenocarcinoma. J Thorac Oncol. 2012;7(2):457–8.CrossRef
9.
go back to reference Kushima H, Ishii H, Yokoyama A, et al. Lung adenocarcinoma presenting with diffuse multiloculated cystic lesions. Internal Med (Tokyo, Japan). 2013;52(20):2375.CrossRef Kushima H, Ishii H, Yokoyama A, et al. Lung adenocarcinoma presenting with diffuse multiloculated cystic lesions. Internal Med (Tokyo, Japan). 2013;52(20):2375.CrossRef
10.
go back to reference Xue X, Wang P, Xue Q, Wang N, et al. Comparative study of solitary thin-walled cavity lung cancer with computed tomography and pathological findings. Lung Cancer (Amsterdam, Netherlands). 2012;78(1):45–50.CrossRef Xue X, Wang P, Xue Q, Wang N, et al. Comparative study of solitary thin-walled cavity lung cancer with computed tomography and pathological findings. Lung Cancer (Amsterdam, Netherlands). 2012;78(1):45–50.CrossRef
11.
go back to reference Isobe K, Hata Y, Iwata M, et al. An autopsied case of mucinous bronchioloalveolar carcinoma associated with multiple thin-walled cavities. Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society. 2009;47(6):512–7.PubMed Isobe K, Hata Y, Iwata M, et al. An autopsied case of mucinous bronchioloalveolar carcinoma associated with multiple thin-walled cavities. Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society. 2009;47(6):512–7.PubMed
12.
go back to reference Ohdama S, Akagawa S, Matsubara O, et al. Primary diffuse alveolar septal amyloidosis with multiple cysts and calcification. Eur Respir J. 1996;9(7):1569–71.CrossRef Ohdama S, Akagawa S, Matsubara O, et al. Primary diffuse alveolar septal amyloidosis with multiple cysts and calcification. Eur Respir J. 1996;9(7):1569–71.CrossRef
13.
go back to reference Vassallo R, Ryu JH, Schroeder DR, et al. Clinical outcomes of pulmonary Langerhans’-cell histiocytosis in adults. N Engl J Med. 2002;346(7):484–90.CrossRef Vassallo R, Ryu JH, Schroeder DR, et al. Clinical outcomes of pulmonary Langerhans’-cell histiocytosis in adults. N Engl J Med. 2002;346(7):484–90.CrossRef
14.
go back to reference Schonfeld N, Dirks K, Costabel U, et al. A prospective clinical multicentre study on adult pulmonary Langerhans’ cell histiocytosis. Sarcoidosis Vasc Diffuse Lung Dis. 2012;29(2):132–8.PubMed Schonfeld N, Dirks K, Costabel U, et al. A prospective clinical multicentre study on adult pulmonary Langerhans’ cell histiocytosis. Sarcoidosis Vasc Diffuse Lung Dis. 2012;29(2):132–8.PubMed
15.
go back to reference McCormack FX, Travis WD, Colby TV, et al. Lymphangioleiomyomatosis: calling it what it is: a low-grade, destructive, metastasizing neoplasm. Am J Respir Crit Care Med. 2012;186(12):1210–2.CrossRef McCormack FX, Travis WD, Colby TV, et al. Lymphangioleiomyomatosis: calling it what it is: a low-grade, destructive, metastasizing neoplasm. Am J Respir Crit Care Med. 2012;186(12):1210–2.CrossRef
16.
go back to reference Henske EP, McCormack FX. Lymphangioleiomyomatosis-a wolf in sheep's clothing. J Clin Invest. 2012;122(11):3807–16.CrossRef Henske EP, McCormack FX. Lymphangioleiomyomatosis-a wolf in sheep's clothing. J Clin Invest. 2012;122(11):3807–16.CrossRef
17.
go back to reference Ciftci AO, Sanlialp I, Tanyel FC, et al. The association of pulmonary lymphangioleiomyomatosis with renal and hepatic angiomyolipomas in a prepubertal girl: a previously unreported entity. Respiration. 2007;74(3):335–7.CrossRef Ciftci AO, Sanlialp I, Tanyel FC, et al. The association of pulmonary lymphangioleiomyomatosis with renal and hepatic angiomyolipomas in a prepubertal girl: a previously unreported entity. Respiration. 2007;74(3):335–7.CrossRef
Metadata
Title
Lung carcinoma with diffuse cystic lesions misdiagnosed as pulmonary langerhans cell histocytosis: a case report
Authors
Xianhua Gui
Jingjing Ding
Yan Li
Min Yu
Tingting Chen
Mei Huang
Yonglong Xiao
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2020
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-020-1066-5

Other articles of this Issue 1/2020

BMC Pulmonary Medicine 1/2020 Go to the issue