Lepidic Type Lung Adenocarcinoma Masquerading as Chronic Infectious Pneumonia: A Case Report

Abstract

Background:Lepidic-type adenocarcinoma (previously known as bronchioloalveolar carcinoma) represents a unique subtype of lung adenocarcinoma that is characterized by the growth of atypical epithelial cells along pre-existing alveolar structures without evidence of stromal, vascular, or pleural invasion. Its radiographic presentation often overlaps with chronic infections like tuberculosis or fungal disease, which can lead to delays in diagnosis, particularly in endemic areas. Case Presentation:We report the case of a 58-year-old, nonsmoking woman from Swabi, Pakistan, who presented to our institution with progressive shortness of breath, productive cough, chest pain, and constitutional symptoms over two months. She had a history of herpes zoster infection and received empiric antituberculous treatment. Chest radiography demonstrated bilateral patchy opacities and cystic lesions. Multiple sputum studies, GeneXpert, and fungal culture studies were negative for infectious etiologies. Computed tomography demonstrated bilateral multiple consolidations with cavitary nodules and minimal pleural effusion. Bronchoscopic evaluation with transbronchial lung biopsy revealed findings consistent with lung adenocarcinoma, lepidic pattern. Conclusion:When considering individuals with non-resolving pneumonia, especially in patients undergoing infection treatments, the diagnosis of lepidic adenocarcinoma should be given consideration. Early histopathologic diagnosis is important for accurate diagnosis and management, ideally through bronchoscopy and/or lung biopsy.