Invasive Pulmonary Adenocarcinoma with Lepidic Growth Pattern in a Pregnant Patient
| Autor: | Juana R. Garcia-Ramirez, Lourdes N Vélez-Ramírez, Omar Jiménez-Zarazúa, Jose C. Padilla-Lopez, Pedro L. Gonzalez-Carillo, Jaime D Mondragón |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Orthopnea
medicine.medical_specialty Peripartum cardiomyopathy Case Report Adenocarcinoma Acute respiratory failure Gastroenterology lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Pregnancy Internal medicine medicine Lung cancer Alveolar infiltrate Solitary pulmonary nodule Lung business.industry medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens CANCER medicine.anatomical_structure 030228 respiratory system Oncology Embolism 030220 oncology & carcinogenesis Lepidic growth medicine.symptom business Postpartum period |
| Zdroj: | Case Reports in Oncology, Vol 11, Iss 3, Pp 822-834 (2018) Case reports in oncology, 11(3), 822-834. KARGER Case Reports in Oncology |
| ISSN: | 1662-6575 |
| Popis: | Among the differential diagnoses that should be considered in acute respiratory failure (ARF) are infectious processes, autoimmune diseases, interstitial pulmonary fibrosis, and pulmonary neoplasia. Timely diagnosis of lung neoplasia is complicated in the early stages. An opportune diagnosis, as well as the specific treatment, decrease mortality. ARF occurs 1 in 500 pregnancies and is most common during the postpartum period. Among the specific etiologies that cause ARF during pregnancy that must be considered are: (1) preeclampsia; (2) embolism of amniotic fluid; (3) peripartum cardiomyopathy; and (4) trophoblastic embolism. The case of a 36-year-old patient with a 33-week pregnancy and ARF is presented. The patient presented dyspnea while exerting moderate effort that progressed to orthopnea and type 1 respiratory insufficiency. Imaging studies showed bilateral alveolar infiltrates and predominantly right areas of consolidation. Blood cultures, a galactomannan assay and IgG antibodies against mycoplasma pneumoniae, were reported as negative. Autoimmune etiology was ruled out through an immunoassay. A percutaneous pulmonary biopsy was performed and an invasive pulmonary adenocarcinoma with lepidic growth pattern (i.e. lepidic pulmonary adenocarcinoma, LPA) result was reported. This etiology is rare and very difficult to recognize in acute respiratory failure cases. After infectious, autoimmune and interstitial lung fibrosis have been excluded the clinician must suspect of lung cancer in a patient with acute respiratory failure and chest imaging compatible with the presence of ground-glass nodular opacities, a solitary nodule or mass with bronchogram, and lung consolidation. In the presence of acute respiratory failure, the suspicion of pulmonary neoplasia in an adult of reproductive age must be timely. Failure to recognize this etiology can lead to fatal results. |
| Databáze: | OpenAIRE |
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