Diagnosis particularities of lung cancer in a young patient without external risk factors – A case report

Lung cancer is the most common type of cancer worldwide, smoking being the strongest risk factor. We present the case of a non-smoker, a 23-year-old patient, without environmental exposure or personal pathological history, who was hospitalised for dry cough, a unique episode of haemoptysis and low-graded fever. He was admitted with a left basal diminished vesicular murmur, without detectable rales, and normal oxygen saturation. The chest X-ray highlighted left pleural effusion in a medium amount. A chest ultrasound revealed also an adjacent pulmonary consolidation. The cytological examination of the pleural fluid detected the presence of lymphocytes 36%, eosinophils 25%, polymorphonuclear 39% and frequent red blood cells. Angio-computer tomography confirmed the existence of a left hilar tumour formation with a mass effect on the hilar structures, possibly a few tumoral emboli in the lateral and posterior basal segmentary arteries, a lower left lobe consolidation, a left pleural effusion with hydroaeric level, and a left pneumothorax. The patient required a fibre bronchoscopy that showed us a proliferative infiltrative process, stenosis of the left lower bronchia, and extrinsic compression of the left lower lobe and the 6th segment. Infiltration of mucosa at the left basal pyramid was also detected. The histological examination argued for pulmonary adenocarcinoma. The particularities of the case consist of the lack of exposure to known risk factors for bronchopulmonary neoplasm and the early appearance of lung cancer and its complications in a young patient.