Bilateral Cavitary Lung Adenocarcinoma In A Young Lady: A Rare Case Report With Review Of Literature

A mucinous variant of bronchioloalveolar carcinoma is described as a rare variant of invasive adenocarcinoma and is characterized radiologically by consolidation, groundglass opacity, and nodules. Here, we report the case of a young lady with multiple cavitary disease presented with respiratory failure and mimicking as tuberculosis, pneumonia, vasculitis but initial laboratory investigations and bronchoscopy couldn’t clinch the diagnosis. Later on, CT-guided biopsy confirmed the diagnosis of mucinous bronchoalveolar carcinoma. Immunohistochemistry for TTF-1, EGFR, ALK, ROS mutation had been sent but the patient requested to discharge, have been put on EGFR inhibitor Gefitinib 250 mg once a day considering adenocarcinoma, female, Asian origin but couldn’t turn-up to review further details. The clinician should be aware of the cavitary presentation of adenocarcinoma of lung even in younger patients where the most common differential is tuberculosis

Not All Primary Osteolytic Mandibular Swelling Is Malignant.

Tubercular infection of the oral tissues can be primary or secondary. Primary lesions develop when tuberculosis bacilli are directly inoculated into the oral tissues of a person who has not acquired immunity to the disease. Here we present a case of 66yrs old non-smoker male presenting with a swelling in the left mandibular region (Lumpy jaw) over a period of last 1yr now presenting with weight loss, pain and trismus for 6month. No past history of tuberculosis or dental extraction. On examination there was a 6x5cm firm to hard nonfluctuant mildly tender swelling with trismus and no palpable cervical lymph nodes. Investigations revealed leucocytosis, ESR 45mm and Mantoux 24mm after 48hrs.PNG radiograph showed osteolytic lesion in angle & body of left mandible with CECT showing retro mandibular trigon extension. USG guided FNAC was consistent with tubercular osteomyelitis with Ziehl Neelsen stain positive for acid fast bacilli. He was started on antitubercular therapy for 9 month showing reduction in size and symptom.

Acute Onset Dyspnea Due To Foreign Body (Pill) Aspiration In Left Main Bronchus.

Abstracts: Aspiration of tracheobronchial foreign commonly affects young children and it is uncommon in adults. Bronchoscopy both flexible and rigid is recommended to reveal the aetiology and therapeutic removal of foreign body aspiration. Here we report a case of pill aspiration presenting with acute onset breathlessness in emergency. Investigation of a case revealed left lung atelectasis on chest X-ray. Further workup by bronchoscopy showed an endobronchial mass lesion in left main bronchus causing left lung atelectasis. The obstruction was removed and patient improved promptly.