A 52-year-old female with a significant smoking history and newly diagnosed chronic obstructive pulmonary disease (COPD) presented to the emergency department with shortness of breath and blood-tinged sputum. Following a prior hospitalization for a COPD exacerbation, imaging revealed atypical features prompting autoimmune evaluations that were negative. A decline in pulmonary function led to admission for bronchoscopy, which revealed invasive mucinous adenocarcinoma (IMA). This case underscores the diagnostic challenges of IMA, which can mimic interstitial lung disease (ILD), resulting in delayed diagnosis and mismanagement. The high false-negative rate of bronchoalveolar lavage cytology in mucinous adenocarcinoma highlights the need for prompt tissue sampling in similar presentations for timely intervention.
Upadhyay et al. (Fri,) studied this question.