Case report
A 20 -year-old nonsmoker young man with no significant medical or
surgical history. There was also no history of high-risk sexual behavior
and no history of drug addiction. He presented to the emergency room
with a grade III dyspnea and non productive cough starting in the last
two months with aggravation in the last 2 days becoming grade IV dyspnea
associated to loss of weight (5 Kg during the last week) and fever.
Physical examination showed tachycardia 120b/min, and temperature of 38,
5°. Respiratory frequency was as 22 cycles/min and saturation measured
at 81%.
The patient was fully conscious with normal neurological examination.
Blood examination showed polyglobulia Hematocrite level at 51% and
hemoglobine level at 18g/dl.
BK simples were negative.
Broncho-alveolar lavage was positive for pneumocytosis.
HIV blood test was negative.
The patient received oxygenotherapy (10L) and was initially placed on
airborne precautions.
A chest plan radiographe showed multiples nodules(Figure1) that were
confirmed on a chest CT afterwords with diffuse nodules some of theme
were excavated nodules associated to some cystic lesions(Figure 2).
Through these results we concluded to a pulmonary pneumocytosis, and the
patient was released and had a controle after 2 weeks.
The patient was re-adimitted to the emergency room five days later with
aggravated respiratory symptoms a new chest CT was performed showing
consolidation in lung bases(Figure 4), we decides to perform a CT guided
percutaneous lung biopsy(Figure 5) that was in favour of an invasive
lung adenocarcinoma with lepidic growth pattern(Figure 6 and 7).The
patient died on the 6th day of his second
hospitalisation from respiratory distress.