13 June 2015 : Case report
Challenging differential diagnosis, Diagnostic / therapeutic accidents, Rare diseaseScott J. DuncanBEF, Dipen KadariaBDEFG
Am J Case Rep 2015; 16:367-370
BACKGROUND: Patients presenting with lung mass and/or nodules are common problems for pulmonologists. The common etiologies for this condition in this area (Ohio River Mississippi Valley area) are malignancy, histoplasmosis, and sarcoidosis. However, there can be other rare causes of this presentation for which a detailed clinical history, examination, and broad knowledge is needed for diagnosis.
CASE REPORT: A 41-year-old woman presented with complaints of progressive nonproductive cough, shortness of breath, and decreased exercise limitation for several months. The symptoms were progressive and were hindering her daily work. Physical examination, including vital signs, was within normal limits. A chest X-ray followed by CT chest was done. CT chest showed a right infrahilar mass 3.5×2.5 cm along with multiple bilateral lung nodules of size 9 to 11 mm. Bronchoscopy with transbronchial needle aspiration (TBNA) and transbronchial biopsy (TBB) and CT-guided biopsy failed to show any diagnosis. Repeat CT scan at follow-up showed the same lesion and the patient had an open-lung biopsy. A diagnosis of benign metastasizing leiomyoma (BML) was made based on clinical, radiological, and histological features, and immunophenotype of the lesion. The patient was started on leuprolide (a GnRH agonist). Follow-up imaging showed decrease in size of lesions. The patient is asymptomatic with increased exercise tolerance.
CONCLUSIONS: Clinicians need to be aware of rare causes of lung mass, like BML. This will help in timely diagnosis and treatment.
Keywords: Bronchoscopy, Biopsy, Diagnosis, Differential, Leiomyoma - diagnosis, Lung Neoplasms - diagnosis, Multiple Pulmonary Nodules - diagnosis, Tomography, X-Ray Computed
28 Sep 2023 : Case reportSurgical Treatment of a Neglected Thumb Volar Plate Injury in an 11-Year-Old Girl: A Case Report
Am J Case Rep In Press; DOI: 10.12659/AJCR.940411
28 Sep 2023 : Case reportIleocolic Intussusception in Infancy is not Always Idiopathic – Adenomyoma as the Leading Point
Am J Case Rep In Press; DOI: 10.12659/AJCR.939789
27 Sep 2023 : Case reportLife-Threatening Cardiac Arrhythmias in a Case of Undetected Myxedema Coma: Importance of Early Detection a...
Am J Case Rep In Press; DOI: 10.12659/AJCR.941414
Most Viewed Current Articles
06 Dec 2021 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406
07 Dec 2021 : Case reportEdwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...
Am J Case Rep 2021; 22:e934347
13 Jul 2022 : Case reportWhistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound
Am J Case Rep 2022; 23:e936441