Recurrent Haemoptysis in Non-Small Cell Lung Cancer Patient
A 70-year-old female who presented with significant haemoptysis over a 7–14 days period. She had a history of a bilateral breast implant for 20 years .Prior for a “left lung collapse. “She subsequently had multiple episodes of cough, fevers, and possible a typical pneumonia TRO Pulmonary Effusion treated with antibiotic Augmentin .Review of her CTPA upon presentation to the hospital showed a severe reduction of left lung volume owing to the volume loss and dense fibrosis at left upper lobe. Presence of calcification within the parenchyma of left upper lobe likely related to previous infection. Collapsed consolidation affecting entire left lower lobe with presence of air bronchgram. There is no pleural effusion overall changes a left lung in favour of superimposed active infection in the background of scarring / chronic lung changes likely as a sequale previous infection. Bronchoscopy showed a multiple fragments of tissue lined by respiratory type epithelium, tumors infiltration is noted in 2 fragments. The tumors cells are large having round to avoid hyper chromatic nuclei and ample amount of eosinophilic cytoplasm. Endobronchial biopsies showed Non-small cell carcinoma with neuroendocrine features. This is a very interesting case of NSCLC which we suspect had a very slow progressive course secondary to the recurrent infection.