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.