Publications
Consolidation with pseudocavitation
Rahaman T, Venkatnarayan K, Veluthat C, Ramachandran P. A 48-year-old man, non-smoker, with no known comorbidities, presented with shortness of breath, cough with mucoid expectoration, loss of appetite and loss of weight for 6 weeks. There was no history of fever, hemoptysis or wheezing. He had received multiple courses of antibiotics from elsewhere before presenting to our centre with no relief of symptoms. On examination, crepitations were audible in the right infrascapular region. Examination of other organ systems and lab investigations were unremarkable. Chest radiograph showed a right lower zone consolidation. CT of the thorax showed right lower lobe consolidation with ground glass opacities with evidence of pseudocavitation. There were multiple nodules with pseudocavity in the other lobes and opposite lung as well (figure 1). With a clinical and radiological suspicion of malignancy, a CT-guided biopsy was done. Histopathological examination showed evidence of neoplastic cells predominantly arranged in a lepidic pattern with glandular formation which were positive for cytokeratin-7 (CK-7) and negative for thyroid transcription factor-1 (TTF-1), Napsin, CK-20 and caudal-type homeobox transcription factor-2 (CDX-2) (figure 2). A diagnosis of mucinous adenocarcinoma with lepidic pattern was made.
