{"title":"Overdiagnosing giant bullous emphysema as metastatic adenocarcinoma: a case report.","authors":"Jiyun Lee, Eunsu Park","doi":"10.1186/s13019-024-03112-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Giant bullous emphysema is characterized by large bullae occupying at least one-third of the hemithorax and leading to compression of the surrounding lung parenchyma. Overdiagnosis can occur because of the atypical appearance of hyperplastic type II pneumocytes, which may be mistaken for malignant cells.</p><p><strong>Case presentation: </strong>A 48-year-old male with a history of smoking and occupational exposure presented with dyspnea and drowsiness. Initial chest X-ray revealed a tension pneumothorax, and subsequent chest CT revealed extensive bullous emphysema and lung cancer in the right middle lobe (RML). Pathologic examination initially indicated resected bullae to metastatic adenocarcinoma, but upon review, it was determined that the reactive alveolar cells were misdiagnosed as malignant.</p><p><strong>Conclusions: </strong>This case emphasizes the need for thorough histopathological assessment and prudent interpretation of atypical cellular morphology.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443899/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiothoracic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13019-024-03112-z","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Giant bullous emphysema is characterized by large bullae occupying at least one-third of the hemithorax and leading to compression of the surrounding lung parenchyma. Overdiagnosis can occur because of the atypical appearance of hyperplastic type II pneumocytes, which may be mistaken for malignant cells.
Case presentation: A 48-year-old male with a history of smoking and occupational exposure presented with dyspnea and drowsiness. Initial chest X-ray revealed a tension pneumothorax, and subsequent chest CT revealed extensive bullous emphysema and lung cancer in the right middle lobe (RML). Pathologic examination initially indicated resected bullae to metastatic adenocarcinoma, but upon review, it was determined that the reactive alveolar cells were misdiagnosed as malignant.
Conclusions: This case emphasizes the need for thorough histopathological assessment and prudent interpretation of atypical cellular morphology.
背景：巨型鼓泡性肺气肿的特征是巨大的鼓泡占据至少三分之一的半胸腔，并导致周围肺实质受压。由于增生的 II 型肺细胞外观不典型，可能被误认为是恶性细胞，因此会出现过度诊断的情况：一名 48 岁男性，有吸烟史和职业接触史，因呼吸困难和嗜睡而就诊。最初的胸部 X 光检查显示有张力性气胸，随后的胸部 CT 显示右中叶（RML）有广泛的鼓泡性肺气肿和肺癌。病理检查最初显示切除的肺大泡为转移性腺癌，但复查后发现反应性肺泡细胞被误诊为恶性肿瘤：本病例强调了对非典型细胞形态进行全面组织病理学评估和审慎解读的必要性。
期刊介绍：
Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields.
Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials.
Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.
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