Round pneumonia
a rare condition mimicking bronchogenic carcinoma. Case report and review of the literature
Keywords:
Pneumonia, Lung neoplasm, Lung diseases, Medical imaging, LungAbstract
CONTEXT: Round pneumonia is a condition usually described in children, with few reports addressing adult patients. It is an oval-shaped consolidation that, due to its radiological appearance, simulates bronchogenic carcinoma. Its evolution tends to be benign, although diagnostic dilemmas have sometimes required exploratory thoracotomy. Deaths caused by this condition have even been reported. To the best of our knowledge, there have been 31 previous cases of round pneumonia in adults reported in the English and Portuguese-language literature, of which only one was completely asymptomatic. CASE REPORT: The case of a 54-year-old female patient presenting a lung mass found on routine imaging evaluation is reported. Respiratory symptoms and signs were absent, but the patient had a signifi cant history of smoking. Her physical examination gave normal results. On chest radiographs, a mass located in the middle third of the right lung was observed. Three weeks after the initial evaluation, the patient was admitted for a complete evaluation and for staging of a pulmonary malignancy, but repeated chest radiographs showed complete resolution.
Downloads
References
Greenfield H, Gyepes MT. Oval-shaped consolidations simulat- ing newgrowth of the lung. Am J Roentgenol Radium Ther Nucl Med. 1964;91:125-31.
Rose RW, Ward BH. Spherical pneumonias in children simulating pulmonary and mediastinal masses. Radiology. 1973;106(1):179-82.
Correa A, Starke J. Infections of the lower respiratory tract in children. In: Niederman MS, Sarosi GA, Glassroth J, editors. Respiratory infections. 2nd ed. Baltimore: Lippincott Williams & Wilkins, 2001. p. 155-70.
Sproul JM. Spherical pneumonia due to Haemophilus influ- enzae. A definitive study by transtracheal aspiration. Am Rev Respir Dis. 1969;100(1):67-9.
Soubani AO, Epstein SK. Life-threatening “round pneumonia”. Am J Emerg Med. 1996;14(2):189-91.
Pandya K, Tuchschmidt J, Gordonson J, Boylen CT. Mass lesion in an intravenous drug user. Round pneumonia. West J Med. 1989;150(1):95-6.
Millard CE, Irwin RS, Braman SS. Acute diffuse pneumonia of asthmatics and concomitant spherical pneumonia. Postgrad Med. 1977;61(4):251-4.
Hershey CO, Panaro V. Round pneumonia in adults. Arch Intern Med. 1988;148(5):1155-7.
Lossos IS, Breuer R. Round pneumonia. Isr J Med Sci. 1989;25(12):713-4.
Durning SJ, Sweet JM, Chambers SL. Pulmonary mass in tachypneic, febrile adult. Chest. 2003;124(1):372-5.
Zinkernagel AS, Schaffner A, Himmelman A. Photo quiz. Round pneumonia due to Streptococcus pneumoniae. Clin Infect Dis. 2001;32(8):1188,1233-4.
Jardim C, Ferreira JC, Takagaki TY, Souza R. Pneumonia redonda com pneumonia pseudotumoral. [Round pneumo- nia with pseudotumoral pneumonia]. Rev Assoc Med Bras. 2003;49(3):240.
Wan YL, Kuo HP, Tsai YH, et al. Eight cases of severe acute respiratory syndrome presenting as round pneumonia. AJR Am J Roentgenol. 2004;182(6):1567-70.
Zylberman M, Cordova E, Farace G. Round pneumonia in adults, an unusual presentation of lung parenchyma infection: a report of two cases and review of the literature. Clinical Pulmonary Medicine. 2006;13(4):229-31. Available from: http://www.clinpulm.com/pt/re/clnpulmed/abstract.00045413-200607000-00002.htm;jsessionid=Lj2p3RNr1mlc96zBSJqcSSBxfdTpNcQRXX1ynbZvKnJvNrH48rXK!-341159882!181195629!8091!-1. Accessed in 2008 (May 8).
Shie P, Farukhi I, Hughes RS, Oz OK. Round pneumonia mimicking pulmonary malignancy on F-18 FDG PET/CT. Clin Nucl Med. 2007;32(1):55-6.
Steiner P, Rao M. Spherical pneumonia. Chest. 1974;66(2):199- 201.
Antón E. A frequent error in etiology of round pneumonia. Chest. 2004;125(4):1592-3.
Wagner AL, Szabunio M, Hazlett KS, Wagner SG. Radiologic manifestations of round pneumonia in adults. AJR Am J Roent- genol. 1998;170(3):723-6.
