Resection of organizing pneumonia with leftover adjacent cystic squamous lung carcinoma: A case report and literature review

Fan,Jing; Cao,Hui; Sun,Fenfen; Ma,Qiang; Zeng,Shasha; Deng,Wei; Cao,Guoqiang

doi:10.3892/etm.2025.12838

Resection of organizing pneumonia with leftover adjacent cystic squamous lung carcinoma: A case report and literature review

Authors:
- Jing Fan
- Hui Cao
- Fenfen Sun
- Qiang Ma
- Shasha Zeng
- Wei Deng
- Guoqiang Cao
View Affiliations

Affiliations: Department of Medicine, Nanan Traditional Chinese Medicine Hospital, Chongqing 400060, P.R. China, Department of Radiology, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing 400042, P.R. China, Department of Respiratory and Critical Care Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing 400042, P.R. China, Department of Pathology, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing 400042, P.R. China, Department of Respiratory and Critical Care Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing 400042, P.R. China
Published online on: March 4, 2025 https://doi.org/10.3892/etm.2025.12838
Article Number: 88

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present case report was to investigate the clinical manifestations, imaging features and changes of tumor markers of organizing pneumonia (OP) complicated by squamous lung carcinoma with cystic air space (LC‑CAS). A patient with OP resection and leftover adjacent LC‑CAS complicated by pneumothorax was evaluated. Relevant reports of OP cases complicated by LC‑CAS before February 2022 were searched in the PubMed, EMBASE, Web of Science, China Biomedical Literature Service System, Wanfang Data, China Journal Network full‑text database and China HowNet databases using ‘lung cancer’ OR ‘lung cancer with cystic air space’ AND ‘organizing pneumonia’ as retrieval terms. After screening relevant reports, no Chinese articles and only one English article (case report) were obtained. The patient in the literature showed signs of dry cough, tachypnea and fever during the early stage of the disease. Chest computed tomography (CT) revealed an irregular consolidation around the lower lobe of the right lung accompanied by a sign of bronchial inflation (usually indicated by a clear bronchial shadow seen in the diseased lung tissue area). A positron emission tomography‑CT (PET‑CT) scan and examination for tumor markers were not performed. OP secondary to LC‑CAS was confirmed by bronchoscopy, and the patient was in a generally good condition 6 months after right lobotomy. The patient in the present case had no obvious discomfort during the early stage of the disease. Chest high‑resolution CT showed that the LC‑CAS had an irregular shape, uneven wall thickness and feeding vessels during the early stage, and cystic cavity consolidation during the later stage of the disease. PET‑CT revealed that the OP exhibited increased ¹⁸F‑fluorodeoxyglucose (18F‑FDG) uptake, whereas the LC‑CAS did not exhibit a high ¹⁸F‑FDG uptake at the early stage, and that the level of tumor markers (such as neuron‑specific enolase, cytokeratin 19 fragment and squamous cell carcinoma antigen) gradually increased. OP was diagnosed through histopathological examination. A total of 32 months after pulmonary lobectomy, bronchoscopy revealed endobronchial neoplasm, and LC‑CAS was diagnosed through biopsy. In conclusion, the present case demonstrates that OP with LC‑CAS is rare, and thus, prone to missed or delayed diagnosis. Therefore, good clinical judgment and continuous learning can help reduce misdiagnosis.

View Figures

View References

1	Shen L, Yu H and Liu J: Advances in imaging studies of latent mechanized pneumonia. J Appl Radiol. 34:133–135. 2018.
2	Baha A, Yildirim F, Kokturk N, Galata Z, Akyürek N, Demirci NY and Türktaş H: Cryptogenic and secondary organizing pneumonia: Clinical presentation, radiological and laboratory findings, treatment and prognosis in 56 cases. Turk Thorac J. 19:201–208. 2018.PubMed/NCBI View Article : Google Scholar
3	Liu J and Cai X: A case of cave-forming focal mechanized pneumonia and literature review. J Hainan Med. 30:395–396. 2019.(In Chinese).
4	Arenas-Jiménez JJ, García-Garrigós E, Ureña Vacas A, Sirera Matilla M and Feliu Rey E: Neumonía organizada. Radiología (Engl Ed). 64 (Suppl 3):S240–S249. 2022.PubMed/NCBI View Article : Google Scholar
5	Cao L, Huang Y and Hua M: Clinical diagnosis and treatment of 42 cases of organizing pneumonia. Chin J Lung Dis. 11:471–473. 2018.(In Chinese).
6	Khan MS, Khateeb F, Akhtar J, Khan Z, Lal A, Kholodovych V and Hammersley J: Organizing pneumonia related to electronic cigarette use: A case report and review of literature. Clin Respir J. 12:1295–1299. 2018.PubMed/NCBI View Article : Google Scholar
7	Lu J, Yin Q, Zha Y, Deng S, Huang J, Guo Z and Li Q: Acute fibrinous and organizing pneumonia: Two case reports and literature review. BMC Pulm Med. 19(141)2019.PubMed/NCBI View Article : Google Scholar
8	Radzikowska E, Nowicka U, Wiatr E, Jakubowska L, Langfort R, Chabowski M and Roszkowski K: Organising pneumonia and lung cancer-case report and review of the literature. Pneumonol Alergol Pol. 75:394–397. 2007.PubMed/NCBI
9	Mascalchi M: Lung cancer associated with cystic airspaces in the screening perspective. Ann Surg Oncol. 27 (Suppl 3):S960–S961. 2020.PubMed/NCBI View Article : Google Scholar
10	Shen Y, Xu X, Zhang Y, Li W, Dai J, Jiang S, Wu T, Cai H, Sihoe A, Shi J and Jiang G: Lung cancers associated with cystic airspaces: CT features and pathologic correlation. Lung Cancer. 135:110–115. 2019.PubMed/NCBI View Article : Google Scholar
11	Tan Y, Gao J, Wu C, Zhao S, Yu J, Zhu R, Zhang Q, Wu G, Xue X and Wu J: CT characteristics and pathologic basis of solitary cystic lung cancer. Radiology. 291:495–501. 2019.PubMed/NCBI View Article : Google Scholar
12	Vlahos I, Stefanidis K, Sheard S, Nair A, Sayer C and Moser J: Lung cancer screening: Nodule identification and characterization. Transl Lung Cancer Res. 7:288–303. 2018.PubMed/NCBI View Article : Google Scholar
13	Fintelmann FJ, Brinkmann JK, Jeck WR, Troschel FM, Digumarthy SR, Mino-Kenudson M and Shepard JO: Lung cancers associated with cystic airspaces: Natural history, pathologic correlation, and mutational analysis. J Thorac Imaging. 32:176–188. 2017.PubMed/NCBI View Article : Google Scholar
14	Pan X, Wang H, Yu H, Chen Z, Wang Z, Wang L and Chen J: Lung cancer associated with cystic airspaces: CT and pathological features. Transl Cancer Res. 9:3960–3964. 2020.PubMed/NCBI View Article : Google Scholar
15	Wang X, Tao YX, Zhang M, Wu WB, Yang DP and Wang M: Solitary thin-walled cystic lung cancer with extensive extrapulmonary metastasis: A case report and review of the literature. Medicine (Baltimore). 97(e12950)2018.PubMed/NCBI View Article : Google Scholar
16	Opoka LM, Szturmowicz M, Oniszh K, Korzybski D, Podgajny Z, Błasińska-Przerwa K, Szołkowska M and Bestry I: CT imaging features of thin-walled cavitary squamous cell lung cancer. Adv Respir Med. 87:114–117. 2019.PubMed/NCBI View Article : Google Scholar
17	Mendoza D, Heeger A, Mino-Kenudson M, Lanuti M, Shepard JO, Sequist LV and Digumarthy SR: Clinicopathologic and longitudinal imaging features of lung cancer associated with cystic airspaces: A systematic review and meta-analysis. AJR Am J Roentgenol. 216:318–329. 2021.PubMed/NCBI View Article : Google Scholar
18	Sheard S, Moser J, Sayer C, Stefanidis K, Devaraj A and Vlahos I: Lung cancers associated with cystic airspaces: Underrecognized features of early disease. Radiographics. 38:704–717. 2018.PubMed/NCBI View Article : Google Scholar
19	Han Y, Ma Y, Wu Z, Zhang F, Zheng D, Liu X, Tao L, Liang Z, Yang Z, Li X, et al: Histologic subtype classification of non-small cell lung cancer using PET/CT images. Eur J Nucl Med Mol Imaging. 48:350–360. 2021.PubMed/NCBI View Article : Google Scholar
20	Snoeck A, Reyntiens P, Carp L, Spinhoven MJ, El Addouli H, Van Hoyweghen A, Nicolay S, Van Schil PE, Pauwels P, van Meerbeeck JP and Parizel PM: Diagnostic and clinical features of lung cancer associated with cystic airspaces. J Thorac Dis. 11:987–1004. 2019.PubMed/NCBI View Article : Google Scholar
21	Erdogan Y, Ozyurek BA, Ozmen O, Yılmaz Demirci N, Duyar SŞ, Dadalı Y, Demirağ F and Karakaya J: The evaluation of FDG PET/CT scan findings in patients with organizing pneumonia mimicking lung cancer. Mol Imaging Radionucl Ther. 24:60–65. 2015.PubMed/NCBI View Article : Google Scholar
22	Aldaghlawi F, Von Holzen U, Li L and Hadid W: A case of squamous cell lung cancer presented as a cystic lesion and recurrent pneumothoraces. Respir Med Case Rep. 33(101382)2021.PubMed/NCBI View Article : Google Scholar
23	Tang X, Liu G, Tan X, Liu C, Xiang J and Jiang Y: Solitary multicystic lesion lung cancer: Two case reports and review of the literature. BMC Pulm Med. 21(368)2021.PubMed/NCBI View Article : Google Scholar
24	Ioannis V, Konstantinos S, Sarah S, Nair A, Sayer C and Moser J: Lung cancer screening: Nodule identification and characterization. Transl Lung Cancer Res. 7:288–303. 2018.PubMed/NCBI View Article : Google Scholar
25	Eichbaum Q, Adkins B, Craig-Owens L, Ferguson D, Long D, Shaver A and Stratton C: Mortality and morbidity rounds (MMR) in pathology: Relative contribution of cognitive bias vs. systems failures to diagnostic error. Diagnosis (Berl). 6:249–257. 2019.PubMed/NCBI View Article : Google Scholar
26	Mazzone PJ, Silvestri GA, Patel S, Kanne JP, Kinsinger LS, Wiener RS, Soo Hoo G and Detterbeck FC: Screening for lung cancer: CHEST guideline and expert panel report. Chest. 153:954–985. 2018.PubMed/NCBI View Article : Google Scholar