<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Pulmonary nodules are single or multiple rounded opacities with a size of minimum 1 cm diameter visualised in the lung parenchyma. From an anatomopathological point of view, they can be benign or malignant. Most often, these nodules are asymptomatic or with minimal symptoms. Now, we present the case of a 62-year-old patient, a smoker, with exposure to occupational respiratory noxious (cellulose industry – 10 years and printing industry – 30 years) without significant personal respiratory pathological history. He has dyspnoea on moderate exertion, irritable cough, myalgia, arthralgia and physical asthenia. The physical examination reveals the presence of a right bayonet sign. Biologically, an inflammatory syndrome was present, the urine test shows no pathological changes, but the imaging is intriguing. On the other side, the imagistic workup [chest X-ray and computed tomography (CT) scan] was quite surprising: micro/macronodular opacities with variable wall thickness, irregular contours and a tendency to confluence at the bilateral lower lobes level. A bronchoscopy was also performed with bronchioloalveolar lavage (BAL) in the right upper lobe (RUL) and bronchial biopsy at the level of the right upper ventral. The hypotheses are multiple: pulmonary rheumatoid nodules, polyangiitis with granulomatosis, lymphangitis carcinomatosis and tuberculosis. Thoracic surgery determined the diagnosis.</p></abstract>

Pulmonary nodules are single or multiple rounded opacities with a size of minimum 1 cm diameter visualised in the lung parenchyma. From an anatomopathological point of view, they can be benign or malignant. Most often, these nodules are asymptomatic or with minimal symptoms. Now, we present the case of a 62-year-old patient, a smoker, with exposure to occupational respiratory noxious (cellulose industry – 10 years and printing industry – 30 years) without significant personal respiratory pathological history. He has dyspnoea on moderate exertion, irritable cough, myalgia, arthralgia and physical asthenia. The physical examination reveals the presence of a right bayonet sign. Biologically, an inflammatory syndrome was present, the urine test shows no pathological changes, but the imaging is intriguing. On the other side, the imagistic workup [chest X-ray and computed tomography (CT) scan] was quite surprising: micro/macronodular opacities with variable wall thickness, irregular contours and a tendency to confluence at the bilateral lower lobes level. A bronchoscopy was also performed with bronchioloalveolar lavage (BAL) in the right upper lobe (RUL) and bronchial biopsy at the level of the right upper ventral. The hypotheses are multiple: pulmonary rheumatoid nodules, polyangiitis with granulomatosis, lymphangitis carcinomatosis and tuberculosis. Thoracic surgery determined the diagnosis.

The unpredictable diagnosis of pulmonary nodules

Pneumologia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"The unpredictable diagnosis of pulmonary nodules"}

Pulmonary nodules are single or multiple rounded opacities with a size of minimum 1 cm diameter visualised in the lung parenchyma. From an anatomopathological...

The unpredictable diagnosis of pulmonary nodules

Published Online: May 28, 2022

Page range: 51 - 54

DOI: https://doi.org/10.2478/pneum-2022-0010

Keywords
Pulmonary nodule, ‘bayonet sign’, cavity, adenocarcinoma

© 2021 Aida-Andreea Fănică et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

The unpredictable diagnosis of pulmonary nodules

Published Online: May 28, 2022

Page range: 51 - 54

DOI: https://doi.org/10.2478/pneum-2022-0010

KeywordsPulmonary nodule, ‘bayonet sign’, cavity, adenocarcinoma

© 2021 Aida-Andreea Fănică et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Pulmonary nodule, ‘bayonet sign’, cavity, adenocarcinoma