Clinics in diagnostic imaging (212)

A 75-year-old woman presented in 2014 with a non-resolving left lower lobe consolidation. Initial less invasive attempts at biopsy of the left lower lobe consolidation failed to obtain a definitive diagnosis, and the patient underwent a left lower lobectomy and lymph node dissection. Histology revea...

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Main Authors: Yong, Glenn Khai Wern, Kwan, Kenneth Eng Ling, Chuah, Khoon Leong, Chai, Gin Tsen
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Journal Article
Language:English
Published: 2022
Subjects:
Online Access:https://hdl.handle.net/10356/162590
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author Yong, Glenn Khai Wern
Kwan, Kenneth Eng Ling
Chuah, Khoon Leong
Chai, Gin Tsen
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Yong, Glenn Khai Wern
Kwan, Kenneth Eng Ling
Chuah, Khoon Leong
Chai, Gin Tsen
author_sort Yong, Glenn Khai Wern
collection NTU
description A 75-year-old woman presented in 2014 with a non-resolving left lower lobe consolidation. Initial less invasive attempts at biopsy of the left lower lobe consolidation failed to obtain a definitive diagnosis, and the patient underwent a left lower lobectomy and lymph node dissection. Histology revealed adenocarcinoma with no lymphovascular invasion, and she was diagnosed with Stage IIA lung adenocarcinoma. She did not require radiotherapy and declined adjuvant chemotherapy. Upper lung changes on initial preoperative computed tomography (CT) of the thorax performed in 2014 (Fig. 1) were originally interpreted to be due to benign post-infectious scarring. The patient subsequently underwent surveillance CT of the thorax over a period of time until 2020. She had no chronic cough, sputum production or worsening exertional dyspnoea over the years. She was a non-smoker and her body mass index (BMI) was 12.6 kg/m2 on her latest review. Her oxygen saturation was 98% on room air, and physical examination revealed reduced breath sounds over the left lung, with bilateral fine crepitations. There were no signs suggestive of a connective tissue disease. An autoimmune screen comprising anti-nuclear antibody, rheumatoid factor and anti-cyclic citrullinated peptide tests was negative, and the patient was unable to produce sputum to screen for acid-fast bacilli. She held multiple jobs previously, including dishwashing, cleaning and being a kitchen helper. What do the initial CT done in 2014 (Fig. 1) and subsequent CT done in 2019 (Fig. 2) show? What is the diagnosis?
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spelling ntu-10356/1625902022-10-31T07:57:19Z Clinics in diagnostic imaging (212) Yong, Glenn Khai Wern Kwan, Kenneth Eng Ling Chuah, Khoon Leong Chai, Gin Tsen Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Diagnostic Imaging Pleuroparenchymal Fibroelastosis A 75-year-old woman presented in 2014 with a non-resolving left lower lobe consolidation. Initial less invasive attempts at biopsy of the left lower lobe consolidation failed to obtain a definitive diagnosis, and the patient underwent a left lower lobectomy and lymph node dissection. Histology revealed adenocarcinoma with no lymphovascular invasion, and she was diagnosed with Stage IIA lung adenocarcinoma. She did not require radiotherapy and declined adjuvant chemotherapy. Upper lung changes on initial preoperative computed tomography (CT) of the thorax performed in 2014 (Fig. 1) were originally interpreted to be due to benign post-infectious scarring. The patient subsequently underwent surveillance CT of the thorax over a period of time until 2020. She had no chronic cough, sputum production or worsening exertional dyspnoea over the years. She was a non-smoker and her body mass index (BMI) was 12.6 kg/m2 on her latest review. Her oxygen saturation was 98% on room air, and physical examination revealed reduced breath sounds over the left lung, with bilateral fine crepitations. There were no signs suggestive of a connective tissue disease. An autoimmune screen comprising anti-nuclear antibody, rheumatoid factor and anti-cyclic citrullinated peptide tests was negative, and the patient was unable to produce sputum to screen for acid-fast bacilli. She held multiple jobs previously, including dishwashing, cleaning and being a kitchen helper. What do the initial CT done in 2014 (Fig. 1) and subsequent CT done in 2019 (Fig. 2) show? What is the diagnosis? 2022-10-31T07:57:19Z 2022-10-31T07:57:19Z 2022 Journal Article Yong, G. K. W., Kwan, K. E. L., Chuah, K. L. & Chai, G. T. (2022). Clinics in diagnostic imaging (212). Singapore Medical Journal, 63(2), 74-78. https://dx.doi.org/10.11622/smedj.2022037 0037-5675 https://hdl.handle.net/10356/162590 10.11622/smedj.2022037 35466388 2-s2.0-85128308095 2 63 74 78 en Singapore Medical Journal © Singapore Medical Association. All rights reserved.
spellingShingle Science::Medicine
Diagnostic Imaging
Pleuroparenchymal Fibroelastosis
Yong, Glenn Khai Wern
Kwan, Kenneth Eng Ling
Chuah, Khoon Leong
Chai, Gin Tsen
Clinics in diagnostic imaging (212)
title Clinics in diagnostic imaging (212)
title_full Clinics in diagnostic imaging (212)
title_fullStr Clinics in diagnostic imaging (212)
title_full_unstemmed Clinics in diagnostic imaging (212)
title_short Clinics in diagnostic imaging (212)
title_sort clinics in diagnostic imaging 212
topic Science::Medicine
Diagnostic Imaging
Pleuroparenchymal Fibroelastosis
url https://hdl.handle.net/10356/162590
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