title: Solitary lung masses due to occult aspiration.
abstract: BACKGROUND
  Aspiration occurs commonly, at times clinically occult, and is recognized to cause a widening spectrum of lung disorders. Presentation of aspiration as a lung mass has not been described.
  
  
  METHODS
  Among cases of aspiration-related pulmonary diseases diagnosed at Mayo Clinic (Rochester, Minn) from 2007 to 2013, 3 patients were identified to have presented with a solitary lung mass lesion.
  
  
  RESULTS
  The age of 3 patients, all men with a history of gastroesophageal reflux disease, ranged from 53 to 65 years. All patients presented with dyspnea, cough, and intermittent fevers. Chest computed tomography in each patient demonstrated malignant-appearing solitary lung mass, cavitated in 2 patients. Two patients underwent positron emission tomography, which showed intense fluorodeoxyglucose uptake in the lung mass for both. Surgical lung resection revealed acute and organizing pneumonia with giant cell reaction to foreign material, consistent with aspiration in all 3 patients. None of these lung masses were located in the "dependent" (posterior or basal) lung zones. These patients were managed with antireflux medical therapy; 1 patient underwent a Nissen fundoplication procedure for recurrent symptoms. No additional aspiration-related complications occurred during the follow-up period ranging from 24 to 84 months.
  
  
  CONCLUSIONS
  Aspiration-related pulmonary complications can present as a solitary lung mass that may not be located in dependent lung zones, which have traditionally been associated with aspiration-related pulmonary diseases.
authors.affiliation: Division of Respiratory Medicine, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China.
authors.forename: Xiaowen
authors.initials: X
authors.lastname: Hu
authors.affiliation: Division of Anatomic Pathology, Mayo Clinic, Rochester, Minn.
authors.forename: Eunhee S
authors.initials: ES
authors.lastname: Yi
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minn. Electronic address: ryu.jay@mayo.edu.
authors.forename: Jay H
authors.initials: JH
authors.lastname: Ryu
mesh_terms: D000368:Aged; D005549:Foreign-Body Reaction / Q000150:complications / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery
keywords: Aspiration pneumonia; Lung neoplasms; Respiratory aspiration