Correct!
4. All of the above
The differential diagnosis for chronic cavitary consolidation should include neoplasia, particularly primary pulmonary malignancies, such as adenocarcinoma, but also lymphoma. Infection remains with the differential diagnosis, however. While coccidioidomycosis is less likely given the negative testing, negative serology does not necessarily exclude this diagnosis. Furthermore, other indolent infections, including other endemic fungi, or even cryptococcosis, as well as nocardiosis and actinomycosis, could present in this manner.
The patient’s percutaneous transthoracic needle biopsy showed mucinous adenocarcinoma with tumor markers consistent with lung origin.
Diagnosis: Mucinous adenocarcinoma presenting as persistent left lower lobe consolidation
References
- Sung YM, Lee KS, Kim BT, Han J, Lee EJ. Lobar mucinous bronchioloalveolar carcinoma of the lung showing negative FDG uptake on integrated PET/CT. Eur Radiol. 2005;15(10):2075-8. [CrossRef] [PubMed]
- Lee KS, Kim Y, Han J, Ko EJ, Park CK, Primack SL. Bronchioloalveolar carcinoma: clinical, histopathologic, and radiologic findings. Radiographics. 1997;17(6):1345-57. [CrossRef] [PubMed]
- Austin JH, Garg K, Aberle D, Yankelevitz D, Kuriyama K, Lee HJ, Brambilla E, Travis WD. Radiologic implications of the 2011 classification of adenocarcinoma of the lung. Radiology. 2013;266(1):62-71. [CrossRef] [PubMed]
- Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/American thoracic society/European respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6(2):244-85. [CrossRef] [PubMed]
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