1. bookVolume 70 (2021): Issue 1 (June 2021)
Journal Details
License
Format
Journal
eISSN
2247-059X
First Published
31 Jan 1951
Publication timeframe
1 time per year
Languages
English
access type Open Access

The unpredictable diagnosis of pulmonary nodules

Published Online: 28 May 2022
Volume & Issue: Volume 70 (2021) - Issue 1 (June 2021)
Page range: 51 - 54
Journal Details
License
Format
Journal
eISSN
2247-059X
First Published
31 Jan 1951
Publication timeframe
1 time per year
Languages
English
Abstract

Pulmonary nodules are single or multiple rounded opacities with a size of minimum 1 cm diameter visualised in the lung parenchyma. From an anatomopathological point of view, they can be benign or malignant. Most often, these nodules are asymptomatic or with minimal symptoms. Now, we present the case of a 62-year-old patient, a smoker, with exposure to occupational respiratory noxious (cellulose industry – 10 years and printing industry – 30 years) without significant personal respiratory pathological history. He has dyspnoea on moderate exertion, irritable cough, myalgia, arthralgia and physical asthenia. The physical examination reveals the presence of a right bayonet sign. Biologically, an inflammatory syndrome was present, the urine test shows no pathological changes, but the imaging is intriguing. On the other side, the imagistic workup [chest X-ray and computed tomography (CT) scan] was quite surprising: micro/macronodular opacities with variable wall thickness, irregular contours and a tendency to confluence at the bilateral lower lobes level. A bronchoscopy was also performed with bronchioloalveolar lavage (BAL) in the right upper lobe (RUL) and bronchial biopsy at the level of the right upper ventral. The hypotheses are multiple: pulmonary rheumatoid nodules, polyangiitis with granulomatosis, lymphangitis carcinomatosis and tuberculosis. Thoracic surgery determined the diagnosis.

Keywords

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