Coincidental Lung Mass Diagnosis in COVID-19 Infected Patient: A Case Report

Abstract

Introduction: COVID-19 (Corona Virus Disease-19) is a newly discovered virus that caused pandemic infection worldwide. The imaging methods are crucial for diagnosis and follow-up in this infectious period. In this article, a case with coronavirus, which was diagnosed as lung cancer incidentally, is presented. Case report: A 41-year-old man presented to the emergency room with cough, fever, and shortness of breath. On examination, breathing sounds changed by listening in the lung. Lung computerized tomography was performed due to shortness of breath while waiting for the PCR test. In addition to the findings of atypical viral pneumonia compatible with coronavirus infection in the tomography, there was a 44x64mm mass in the right lung middle lobe. Coronavirus treatment was initiated in the patient, whose PCR test was positive. The patient who responded to the treatment after one week was diagnosed as lung cancer as a result of the biopsy. Conclusion: In the diagnosis of COVID-19, imaging has a crucial role. Incidental findings are commonly detected by computed tomography.

Keywords

• coronavirus,incidental mass,lung cancer,computed tomography,COVID-19

Korona Virus Enfekte Olguda Rastlantısal Akciğer Kitle Tanısı: Bir Olgu Sunumu

Abstract

Giriş: Korona virus tüm dünyada pandemiye neden olan yeni keşfedilmiş bir virustur. Görüntüleme yönteminin tanı ve takite oldukça önemli olduğu görülmüştür. Bu yazıda 41 yaşında korona enfeksiyonu esnasında çekilen bilgisayarlı toraks tomografisi ile insidental olarak akciğer kanseri tanısı alan bir olgu sunulmuştur.

Olgu Sunumu: 41 yaşında erkek hasta öksürük, ateş ve nefes darlığı ile acil servise başvurdu. Muayenesinde akciğerde dinlemekle solunum sesleri değişmişti. PCR testi yapılan olguda nefes darlığı olması nedeniyle Akciğer bilgisayarlı tomografi çekildi. Tomografide korona virus enfeksiyonu ile uyumlu atipik viral pneumoni bulgularının yanında sağ akciğer orta lobda 44x64 mm kitle mevcuttu. PCR testi pozitif gelen olgunun korona virus tedavisi başlandı. 1 hafta sonra tedaviye cevap veren olguda biyopsi sonucu akciğer kanseri tanısı konuldu.

Sonuç: Korona virus enfeksiyon tanısında görüntüleme oldukça önem arzetmektedir. İnsidental bulgular sıklıkla Bilgisayarlı Tomografi tarafından tespit edilmiştir.

Keywords

• Koronavirüs,Rastlantısal kitle,Akciğer kanseri,Bilgisayarlı tomografi,KOVID-19

References

1. 1. Das KM, Lee EY, Al Jawder SE, Enani MA, Singh R, Skakni L, et al. Acute Middle East Respiratory Syndrome Coronavirus: Temporal Lung Changes Observed on the Chest Radiographs of 55 Patients. AJR Am J Roentgenol. 2015 Sep;205(3):W267-74. doi: 10.2214/AJR.15.14445. Epub 2015 Jun 23.
2. 2. Zhong Z, Hu Y, Yu Q, Li Y, Li P, Huang W, et al. Multistage CT features of coronavirus disease 2019. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Mar 28;45(3):250-256. doi: 10.11817/j.issn.1672-7347.2020.200144.
3. 3. Bhat R, Hamid A, Kunin JR, Saboo SS, Batra K, Baruah D et al. Chest Imaging in Patients Hospitalized With COVID-19 Infection - A Case Series. Curr Probl Diagn Radiol. 2020 Apr 11. pii: S0363-0188(20)30055-4. doi: 10.1067/j.cpradiol.2020.04.001.
4. 4. Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA. 2020 Mar 13. doi:10.1001/jama.2020.4031. [Epub ahead of print]
5. 5. Ozdemir O. Coronavirus Disease 2019 (COVID-19): Diagnosis and Management (Narrative Review). Erciyes Med J 2020; 42(3): 00–00 • DOI: 10.14744/etd.2020.99836
6. 6. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497–506.
7. 7. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395(10223): 507–13. DOI:https://doi.org/10.1016/S0140-6736(20)30211-7
8. 8. Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology. 2020 Mar 10:200823. doi: 10.1148/radiol.2020200823. [Epub ahead of print]

9. 9. Huang P, Liu T, Huang L, Liu H, Lei M, Xu W, et al. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology 2020; 295(1): 22–3. https://doi.org/10.1148/radiol.2020200330
10. 10. Albano D, Bertagna F, Bertoli M, Bosio G, Lucchini S, Motta F, et al. Incidental Findings Suggestive of COVID-19 in Asymptomatic Patients Undergoing Nuclear Medicine Procedures in a High-Prevalence Region. J Nucl Med. 2020 May;61(5):632-636. DOI: 10.2967/jnumed.120.246256
11. 11. Karcıoğlu Ö. What is Coronaviruses, and how can we protect ourselves? Coronavirüs nedir, nasıl korunabiliriz? Phnx Med J. 2020;March, 2 (1): 66-71.