Abstract
We experienced a case of lung abscess misdiagnosed as adenocarcinoma based on cytologic findings of the sample obtained from transbronchial brushing. In May 2001, a 46-year-old man who complained of right anterior chest pain was referred for further examination regarding an abnormal shadow detected in the middle lobe of the right lung on chest CT. Pathologic findings by transbronchial direct biopsy showed only inflammatory granulomas, whereas a brushed sample revealed atypical cells. A diagnosis of adenocarcinoma was made. A right upper and middle lobectomy accompanied with partial resection of the right lower lobe was performed. Pathological findings of the resected specimen showed a lung abscess with organizing pneumonia, but no evidence of malignant neoplasm. Atypical cells were seen among the inflammatory cells, but only as part of the inflammatory focus.
Diagnosis should not be made on cytologic findings alone, because of the possibility of false-positive results. In that case, further examination should be made pre or intraoperatively.
