A case of solitary pulmonary infarction mimicking lung carcinoma

Abstract

A 67-year-old man underwent wedge resection for early-stage lung cancer of the left lower lobe. The pathological diagnosis was adenocarcinoma in situ (AIS) with a 100% lepidic growth pattern. Three months after the resection, a single pure ground-glass nodule (GGN) of 10 mm in diameter was detected in the left upper lobe on follow-up computed tomography (CT). After another three-month follow-up, the pure GGN lesion was changed to a solid nodule with pleural indentation. Positron emission tomography (PET) showed abnormal uptake to the nodule with a maximal standardized uptake value (SUV-max) of 1.7. Since malignancy could not be excluded, wedge resection was performed. Pathological findings revealed that the lesion was a pulmonary infarction. Pulmonary infarction generally presents as multiple nodal lesions on CT. In this case, a solitary pure GGN was first recognized, which changed to a solid nodule later. These findings are consistent with the time course of pathological findings; therefore, it is considered that we could verify the time course of CT findings. Moreover, since these findings are similar to those of lung cancer, it is suggested that we should be careful on conducting a differential diagnosis.