"When Wheezing Is Not Asthma: Recognizing Alternative Causes, Including" by Pawan Gyawali, Bikash Khanal et al.
 

When Wheezing Is Not Asthma: Recognizing Alternative Causes, Including Mucoepidermoid Carcinoma

Document Type

Conference Proceeding

Publication Date

5-2025

Publication Title

American Journal of Respiratory and Critical Care Medicine

Abstract

Introduction Mucoepidermoid carcinoma is a rare salivary gland-type primary malignancy of the respiratory tract and accounts for 0.1 to 0.2 percent of primary lung carcinoma. It contains mucus-secreting, squamous and intermediate cells. While mostly an indolent low-grade tumor involving central airways, it can metastasize to lymph nodes and multiple organs in up to one third of patients. Case Description · An 18-year-old female patient with a history of asthma presented with a persistent cough, dyspnea, and wheezing for a period of three months. · During this time, she received multiple courses of antibiotics and steroids, but her symptoms persisted. · She did not experience hemoptysis or weight loss. · Chest X-rays revealed consolidation of the right middle lobe during this period. · A computed tomography (CT) scan of the thorax was performed due to concerns for an obstructive lesion, which revealed consolidation of the right middle lobe with a small nodule in the right costophrenic angle of the right middle lobe. · Fluorodeoxyglucose positron emission tomography (FDG PET) was conducted, which demonstrated focal uptake in the lesion but no evidence of lymph node or distant uptake. · Bronchoscopy was performed, which revealed a fleshy mass in the right middle lobe that was suspicious of a tumor. This lesion was sensitive to manipulation, causing hyperemia and bleeding. · Endobronchial biopsy confirmed the diagnosis of low-grade mucoepidermoid carcinoma based on histopathological examination. Management · Thoracotomy with right middle and lower lobe lobectomy was performed. · Postoperatively, she required chest tube drainage for several days due to pleural effusion, air leak, and pneumothorax. · At 6-months post-lobectomy, she was asymptomatic but had minimal pneumothorax and pleural effusion on the right side. No intervention was necessary. Follow-up · She has not had a recurrence since the lobectomy · While she was noted to have possible asthma before her surgery, she has not needed treatment for asthma since. Discussion · Mucoepidermoid carcinoma of the lung is a rare salivary gland-type tumor. · It is crucial to consider obstructive airway lesions, such as mucoepidermoid carcinoma, as differential diagnoses for wheezing and recurrent pneumonia, particularly when the lesion involves the same lobe.

Volume

211

First Page

A2808

Comments

American Thoracic Society (ATS) International Conference, May 16-21, 2025, San Francisco, CA

Last Page

A2808

DOI

10.1164/ajrccm.2025.211.Abstracts.A2808

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