AGGRESSIVE LUNG ADENOCARCINOMA PRESENTING WITH EXTENSIVE LYMPHADENOPATHY MIMICKING LYMPHOMA: A DIAGNOSTIC CHALLENGE

Abstract

Micropapillary adenocarcinoma represents uncommon but highly aggressive variant of non-small cell lung cancer (NSCLC), identified for a tendency for early micro metastasis, especially to mediastinal and extra thoracic lymph nodes. The report presents a case of a 61-year-old male diagnosed with lung adenocarcinoma, characterised by rapid clinical progression. The patient experienced two hospitalisations, with a diagnostic process that was both prolonged and complex. Initially, a suspected right lung mass was identified, which was subsequently reevaluated as a potential lymphoma. After three weeks of initial admission, the patient exhibited getting worse clinical and radiological signs, including superior vena cava syndrome (SVCS), requiring emergency intervention before a confirmed cancer diagnosis. Despite the performance of both bronchoscopy and an excisional biopsy of supraclavicular lymphadenopathy, a definitive diagnosis was not accomplished. Lung adenocarcinoma was eventually confirmed after two procedures of histopathological evaluation of fine-needle aspiration biopsy (FNAB) specimens. The patient's condition got worse, lead to death shortly after diagnosis, prior to the administration of chemotherapy. This case highlights the significant effects of diagnostic delay in aggressive lung cancer subtypes, emphasising the necessity of early identification and prompt treatment to enhance prognosis and survival outcomes.