Feng SL, Li JY, Dong CL. Primary biliary cholangitis presenting with granulomatous lung disease misdiagnosed as lung cancer: A case report. World J Clin Cases 2024; 12(2): 354-360 [PMID: 38313637 DOI: 10.12998/wjcc.v12.i2.354]
Corresponding Author of This Article
Chun-Ling Dong, PhD, Chief Physician, Department of Respiratory and Critical Care Medicine, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. cldong@jlu.edu.cn
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 16, 2024; 12(2): 354-360 Published online Jan 16, 2024. doi: 10.12998/wjcc.v12.i2.354
Primary biliary cholangitis presenting with granulomatous lung disease misdiagnosed as lung cancer: A case report
Shan-Li Feng, Jun-Yao Li, Chun-Ling Dong
Shan-Li Feng, Jun-Yao Li, Chun-Ling Dong, Department of Respiratory and Critical Care Medicine, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
Author contributions: Feng SL wrote the original draft; Feng SL and Dong CL collected and analyzed the clinical data; Dong CL and Li JY reviewed and edited the manuscript; Dong CL contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Supported byThe Special Health Project of the Department of Finance of Jilin Province, China, No. 2020SCZT023 and No. 3D5177713429.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Ling Dong, PhD, Chief Physician, Department of Respiratory and Critical Care Medicine, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun 130041, Jilin Province, China. cldong@jlu.edu.cn
Received: September 19, 2023 Peer-review started: September 19, 2023 First decision: November 22, 2023 Revised: December 6, 2023 Accepted: December 25, 2023 Article in press: December 25, 2023 Published online: January 16, 2024 Processing time: 113 Days and 14.3 Hours
Abstract
BACKGROUND
There are few cases of pulmonary granulomatous changes secondary to primary biliary cirrhosis (PBC). No case of granulomatous lung disease secondary to PBC misdiagnosed as lung cancer had been reported.
CASE SUMMARY
A middle-aged woman presented with lung nodules and was misdiagnosed with lung cancer by positron emission tomography/computed tomography. She underwent left lobectomy, and the pathology of the nodules showed granulomatous inflammation, which was then treated with antibiotics. However, a new nodule appeared. Further investigation with lung biopsy and liver serology led to the diagnosis of PBC, and chest computed tomography indicated significant reduction in the pulmonary nodule by treatment with methylprednisolone and ursodeoxycholic acid.
CONCLUSION
Diagnosis of pulmonary nodules requires integrating various clinical data to avoid unnecessary pulmonary lobectomy.
Core Tip: Primary biliary cholangitis (PBC) can present as granulomatous lung disease when the lungs are involved. A patient with pulmonary granulomatous disease secondary to PBC was misdiagnosed with lung cancer by positron emission tomography/computed tomography (PET/CT), leading to unnecessary lobectomy. The symptoms and imaging of pulmonary granulomatous disease secondary to PBC are nonspecific. It also appears as high fluorodeoxyglucose uptake on PET/CT scan. Diagnosis should not rely solely on PET/CT findings but should consider clinical data, lung aspiration biopsy, and immune-related disease indexes to avoid unnecessary physical and financial burden.
