Pulmonary nodule in pediatrics: beyond the infection

Abstract

The study of a pulmonary nodule in pediatrics is a diagnostic challenge where multiple pathologies must be taken into account, especially infections. In developing countries, where tuberculosis infection is endemic, it is one of the most likely diagnoses; however, the diagnostic possibility of malignancy should never be overlooked.

Objective: To describe a case report of a patient with a pulmonary nodule, that after ruling out the most frequent causes, a primary malignant tumor was diagnosed.

Clinical Case: 17-year-old female patient with a one-month history of cough, dyspnea, and hemoptysis, without other symptoms. Since she did not respond to conventional antibiotic management, a chest CT scan with contrast was performed which showed a pulmonary nodule with irregular contours, and with the bronchoalveolar lavage pulmonary infections were ruled out (pulmonary tuberculosis, fungal infection, and others bacteria). Biopsy of the lesion was performed to complete the study which histopathology was compatible with a mucoepidermoid carcinoma (MEC). The patient underwent right low lobectomy and lymph node resection with good clinical response during three years of follow-up.

Conclusion: Pulmonary nodule in pediatrics is a finding usually associated with infection, nevertheless, neoplastic conditions have to be considered, not only metastasis but also primary pulmonary malignant lesions due to prognosis implications.