Case 1: a 58 year- old male with 80 pack-years of cigarettes was hospitalized in our department for the exploration of hemoptysis with cough and sputum, initially diagnosed as pneumonia. There is no history of tuberculosis. Chest auscultation revealed ronchi in left basal region. Complete blood count and blood biochemistry were within normal limits. Sputum was negative for acid fast bacilli or other pathogenic germs. His chest X-ray showed a persistent left basal consolidation (Figure 1). Thoracic CT scan revealed a left-sided bronchialcentric mass in the left main bronchus associated with multiple left hilar lymph nodes and carcinomatous lymphangitis in the left inferior lobe (Figure 2). Cerebral and abdomino-pelvic CT scan did not reveal metastatic lesions. Bronchial fibroscopy showed an endobronchial polypoidal growth in the left main bronchus that entirely occlude the lumen. The histopathological examination of bronchial biopsy showed evidence of adenoid cystic carcinoma (Figure 3). The patient underwent a left pneumonectomy with node dissection. The surgical margins were negative with no node dissemination. A Chest CT performed seven months following surgery didn't show tumor recurrence. The patient is regularly seen at our consultation. He reports an improvement of his symptoms after the surgery.
coronal CT scan image. Left-sided bronchial-centric mass in the left main bronchus (white arrow) associated with multiple left hilar lymph nodes and carcinomatous lymphangitis in the left inferior lobe.