Lung adenocarcinoma mimicking pulmonary fibrosis-a case report.
Lung cancer is usually presented with cough, dyspnea, pain and weight loss, which is overlapping with symptoms of other lung diseases such as pulmonary fibrosis. Pulmonary fibrosis shows characteristic reticular and nodular pattern, while lung cancers are mostly presented with infiltrative mass, thick-walled cavitations or a solitary nodule with spiculated borders. If the diagnosis is established based on clinical symptoms and CT findings, it would be a misapprehension.



We report a case of lung adenocarcinoma whose symptoms as well as clinical images overlapped strongly with pulmonary fibrosis. The patient's non-productive cough, progressive dyspnea, restrictive pattern of pulmonary function test and CT scans (showing reticular interstitial opacities) were all indicative of pulmonary fibrosis. The patient underwent a treatment consisting of corticosteroids and antibiotics, to no avail. Histopathology of the lung showed that the patient suffered from mucinous adenocarcinoma. Albeit the immunohistochemical staining was not consistent with lung adenocarcinoma, tumor's morphological characteristics were consistent, and were used to make the definitive diagnosis.



Given the fact that radiography cannot always make a clear-cut difference between pulmonary fibrosis and lung adenocarcinomas, and that clinical symptoms often overlap, histological examination should be considered as gold standard for diagnosis of lung adenocarcinoma.
Clinic of Pulmonary Diseases and TB, University Clinical Centre of Sarajevo, Bardakčije 90, 71000, Sarajevo, Bosnia and Herzegovina. mehicb@bih.net.ba.
Bakir
B
Mehić
Clinic of Pulmonary Diseases and TB, University Clinical Centre of Sarajevo, Bardakčije 90, 71000, Sarajevo, Bosnia and Herzegovina.
Lina
L
Duranović Rayan
Clinical Pathology and Cytology, University Clinical Centre of Sarajevo, Bolnička 25, 71000, Sarajevo, Bosnia and Herzegovina.
Nurija
N
Bilalović
Clinic of Pulmonary Diseases and TB, University Clinical Centre of Sarajevo, Bardakčije 90, 71000, Sarajevo, Bosnia and Herzegovina.
Danina
D
Dohranović Tafro
Clinic for Thoracic Surgery, University Clinical Centre of Sarajevo, Bolnička 25, 71000, Sarajevo, Bosnia and Herzegovina.
Ilijaz
I
Pilav
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000175:diagnosis*; D012129:Respiratory Function Tests; D012680:Sensitivity and Specificity; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods
Case report; Diagnosis; Interstitial opacities; Lung adenocarcinoma; Progressive dyspnea; Pulmonary fibrosis