EC Clinical and Medical Case Reports

One of the most important reasons for undetected lung cancer by x-ray chest radiography is accompanying bronchopneumonia. It is challenging to distinguish these two clinical entities, so that the diagnosis of lung cancer is not delayed. We present a late-diagnosed case of lung cancer with disseminated metastases in the liver, due to reduced visibility from a bronchopneumonic infiltrate. This case was confirmed by laboratory analyses, tumor markers, computed tomography (CT) and its spread with Doppler echosonography. In summary, we would like to highlight the need for additional diagnosis with CT and the diminished diagnostic value of X-rays in bronchopneumonia.

Keywords: Lung Cancer; Bronchopneumonia; X-Ray Chest Radiography; Doppler Ultrasonography

1. Howlader N., et al. “SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations)”. National Cancer Institute (2009).
2. Royal College of Physicians. London, United Kingdom: Royal College of Physicians; Smoking and health. A report on smoking in relation to lung cancer and other diseases (1962).
3. Stellman SD., et al. “Risk of squamous cell carcinoma and adenocarcinoma of the lung in relation to lifetime filter cigarette smoking”. Cancer3 (1997): 382-388.
4. Safdar A and Armstrong D. “Infectious morbidity in critically ill patients with cancer”. Critical Care Clinics3 (2001): 531-570.
5. Wong JL and Evans SE. “Bacterial pneumonia in patients with cancer: novel risk factors and management”. Clinics in Chest Medicine2 (2017): 263-277.
6. Satoru N. “CT findings of pneumonic adenocarcinoma: comparison between invasive mucinous adenocarcinoma and nonmucinous adenocarcinoma”. Global Journal for Research 14 (2014): 1-4.
7. Van Beek EJ., et al. “Lung cancer screening: Computed tomography or chest radiographs?” World Journal of Radiology8 (2015): 189-193.
8. Brenner DJ. “Radiation risks potentially associated with low-dose CT screening of adult smokers for lung cancer”. Radiology 231 (2004): 440-445.
9. Petar Avramovski., et al. “Improved detection of metastases by Color Doppler ultrasonography”. Research and Review Insights1 (2017): 1-3.
10. Turkington PM., et al. “Misinterpretation of the chest x ray as a factor in the delayed diagnosis of lung cancer”. Postgraduate Medical Journal 78 (2002): 158-160.
11. Quekel LG., et al. “The limited detection of lung cancer on chest X-rays”. Nederlands Tijdschrift voor Geneeskunde22 (2003): 1048-1056.
12. DiBonito L., et al. “Cytological typing of primary lung cancer: study of 100 cases with autopsy confirmation”. Diagnostic Cytopathology1 (1991): 7-10.
13. Tas F., et al. “Serum lactate dehydrogenase levels at presentation predict outcome of patients with limited-stage small-cell lung cancer”. American Journal of Clinical Oncology4 (2001): 376-378.
14. Jing Jing Ran., et al. “Increased γ-glutamyl transferase positively contributed to the poor prognosis in lung cancer patients”. Translational Research6 (2018).