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Title: Clinics in diagnostic imaging (212)
Authors: Yong, Glenn Khai Wern
Kwan, Kenneth Eng Ling
Chuah, Khoon Leong
Chai, Gin Tsen
Keywords: Science::Medicine
Issue Date: 2022
Source: 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.
Journal: Singapore Medical Journal 
Abstract: 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?
ISSN: 0037-5675
DOI: 10.11622/smedj.2022037
Rights: © Singapore Medical Association. All rights reserved.
Fulltext Permission: none
Fulltext Availability: No Fulltext
Appears in Collections:LKCMedicine Journal Articles

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