A 61-year-old woman was referred to our out-patient clinic for evaluation and treatment of pneumonia, which was unresponsive to antimicrobial agents. The patient was admitted for a thorough antimicrobial-resistant pneumonia examination. Subsequently, the patient’s condition rapidly declined, leading to the postponement of bronchoscopy. Treatment was initiated based on the clinical assumption of a diagnosis of organizing pneumonia. The patient survived the acute phase. Steroids were gradually tapered off on an out-patient basis. However, various symptoms appeared during the disease course, which could not be completely attributed to steroid side-effects. Therefore, multiple diagnostic tests were performed, leading to a diagnosis of neuromyelitis optica. Organizing pneumonia is a complication of various diseases. Hence, neuromyelitis optica may have been a preexisting condition. The corticosteroids used to treat the organizing pneumonia may have masked the symptoms of neuromyelitis optica, interfering with definitive diagnosis.

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A 69-year-old male heavy smoker presented with a chest abnormal shadow at a medical health checkup and was referred to our hospital. He was diagnosed with squamous cell lung carcinoma (cT4N3M1a, Stage IVA) by bronchoscopy and systemic radiological examinations. Next generation sequencing of biopsy samples using OncomineTM Dx Target Test® revealed positive for anaplastic lymphoma kinase (ALK) fusion gene. Six months after treatment with alectinib, complete response was achieved without adverse events. Molecular testing for oncogenic drivers would be considered in patients with squamous cell carcinoma.

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