Document Type

Article

Publication Date

5-2016

Abstract

A 59-year-old male patient developed a new 4 cm × 6 cm cavitary left upper lung lesion over a 2 months period. The patient had a prior history of a surgically resected Stage IA non-small cell lung cancer in the right upper lobe 3 years prior. He was treated for possible infection with radiographic improvement on subsequent imaging. Further imaging after 3 months revealed an oval soft tissue density within the cavity with air crescent sign. Bronchoscopy with transbronchial biopsies showed an acute and chronic granulomatous inflammation. Aspergillus fumigatus was noted on culture and voriconazole was initiated. Subsequent imaging showed initial improvement and then the stability of cavity size. However, 11 months later, the medial wall of the cavity showed increased thickness. Bronchoscopy showed no endobronchial lesions. Esophageal ultrasound-guided fine-needle aspiration using the endobronchial curvilinear endoscopic ultrasound bronchoscope was performed for a sampling of the cavity wall that was abutting the mediastinum. The aspirate showed squamous cell lung cancer and the patient was started on therapy after appropriate staging.

Comments

The version of record is at https://dx.doi.org/10.4103%2F2303-9027.208171.

Copyright © 2017 Spring Media Publishing Co. Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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