Invasive mucinous adenocarcinoma mimicking organizing pneumonia associated with Mycobacterium fortuitum infection

Intern Med. 2014;53(24):2795-9. doi: 10.2169/internalmedicine.53.2783. Epub 2014 Dec 15.

Abstract

We herein report the case of a 68-year-old man diagnosed with invasive mucinous adenocarcinoma of the lungs. Chest computed tomography showed subpleural ground-glass opacity and small nodules with cavitation. A culture of the bronchoalveolar lavage fluid resulted in the detection of Mycobacterium fortuitum. The patient's lung consolidation rapidly progressed; however, repeated bronchoscopy showed no atypical cells, thus suggesting a diagnosis of organizing pneumonia associated with M. fortuitum infection. However, the surgical biopsy specimen was diagnostic for adenocarcinoma, with no mycobacterial infection. Invasive mucinous adenocarcinoma should not be excluded in the differential diagnosis of patients with clinical features of organizing pneumonia and nontuberculous mycobacterium infection, even if a transbronchial biopsy confirms the absence of malignancy.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma, Mucinous / complications
  • Adenocarcinoma, Mucinous / diagnosis*
  • Adenocarcinoma, Mucinous / pathology
  • Aged
  • Bronchoalveolar Lavage Fluid / microbiology
  • Bronchoscopy / methods
  • Diagnosis, Differential
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / pathology
  • Male
  • Mycobacterium Infections, Nontuberculous / diagnosis*
  • Mycobacterium Infections, Nontuberculous / microbiology*
  • Mycobacterium fortuitum / isolation & purification*
  • Pneumonia, Bacterial / diagnosis*
  • Pneumonia, Bacterial / microbiology*